Stereotactic Gamma Knife surgery safety and efficacy in the management of symptomatic benign confined XXXX .

@entity1 @entity129 @entity41 @entity5 @entity15265
BACKGROUND: Considering the proximity to cranial nerves from II to VI and the internal carotid artery microsurgery for @entity15265 ( @entity15265 ) has its limits of complete resection, with high potential @entity5 recurrences, cranial nerve and vascular morbidity. Gamma Knife surgery (GKS) is an advanced modality as primary treatment for @entity1 harboring symptomatic benign confined @entity15265 as well as adjuvant therapy to postoperative @entity41 giving a high rate of @entity5 control, stabilizing or even improving clinical condition with low morbidity. MATERIALS AND METHODS: The aim of this study is to evaluate the safety and efficacy of GKS used in the management of 62 @entity1 with symptomatic benign confined @entity15265   <   3  cm in maximum diameters treated at the International Medical Centre (IMC), Cairo, Egypt, from 2005 to end of 2012, with mean follow-up period of 36  months (range, 24-96  months) by reviewing their clinical and radiological data. For 51 @entity1 GKS was performed as a primary treatment. The diagnosis was based on typical clinical and imaging findings and in 11 @entity1 GKS was used as adjuvant to post-operative @entity5 residual with histological confirmation. RESULTS: There were 43 females and 19 males. The median age at the time of treatment was 48  years. The mean @entity5 volume was 5.7  cc, the mean @entity5 marginal radiation dose was 14.4  Gy, the mean isodose line was 38  %, and the mean @entity5 coverage was 94.4  %. The optic pathway received    <   8  Gy and the brain stem    <   10  Gy. At most recent follow-up, 57 @entity1 (92  %) had stable or improved @entity129 . @entity129 were detected in five @entity1 (8  %). @entity5 volume was controlled in 60 @entity1 (96  %) at most recent follow-up MRI; 12 @entity1 had a reduction in @entity5 size and 42 had stable @entity5 size, while @entity5 size progression was detected in two @entity1 . The @entity5 progression-free survival at 3 and 5  years in 40 @entity1 who completed at least 5  years of follow-up was 95  %. CONCLUSIONS: Gamma Knife surgery is a safe and effective option for the treatment of @entity15265 not only as an adjuvant to surgery but also as an alternative to surgical @entity5 confined mainly to the cavernous sinus.
