Single-session Gamma Knife radiosurgery for optic pathway/hypothalamic gliomas

• Published in: Journal of neurosurgery Vol. 125; no. Suppl 1; p. 50
• Main Authors: El-Shehaby, Amr M N, Reda, Wael A, Abdel Karim, Khaled M, Emad Eldin, Reem M, Nabeel, Ahmed M
• Format: Journal Article
• Language: English
• Published: United States 01.12.2016
• Subjects: Adolescent; Adult; Child; Child, Preschool; Female; Glioma - radiotherapy; Humans; Hypothalamic Neoplasms - radiotherapy; Male; Optic Chiasm; Optic Nerve Neoplasms - radiotherapy; Optic Tract; Radiosurgery - adverse effects; Radiosurgery - methods; Retrospective Studies; Treatment Outcome; Young Adult; EBRT = external-beam radiotherapy; fractionation; MRS = MR spectroscopy; hypothalamic; single session; glioma; Gamma Knife; optic; stereotactic radiosurgery
• ISSN: 1933-0693
• DOI: 10.3171/2016.8.gks161432

OBJECTIVE Because of their critical and central location, it is deemed necessary to fractionate when considering irradiating optic pathway/hypothalamic gliomas. Stereotactic fractionated radiotherapy is considered safer when dealing with gliomas in this location. In this study, the safety and efficacy of single-session stereotactic radiosurgery for optic pathway/hypothalamic gliomas were reviewed. METHODS Between December 2004 and June 2014, 22 patients with optic pathway/hypothalamic gliomas were treated by single-session Gamma Knife radiosurgery. Twenty patients were available for follow-up for a minimum of 1 year after treatment. The patients were 5 to 43 years (median 16 years) of age. The tumor volume was 0.15 to 18.2 cm (median 3.1 cm ). The prescription dose ranged from 8 to 14 Gy (median 11.5 Gy). RESULTS The mean follow-up period was 43 months. Five tumors involved the optic nerve only, and 15 tumors involved the chiasm/hypothalamus. Two patients died during the follow-up period. The tumors shrank in 12 cases, remained stable in 6 cases, and progressed in 2 cases, thereby making the tumor control rate 90%. Vision remained stable in 12 cases, improved in 6 cases, and worsened in 2 cases in which there was tumor progression. Progression-free survival was 83% at 3 years. CONCLUSIONS The initial results indicate that single-session Gamma Knife radiosurgery is a safe and effective treatment option for optic pathway/hypothalamic gliomas.