Skip to main content
Top
Published in: Journal of Neuro-Oncology 3/2018

01-09-2018 | Clinical Study

Clinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife® stereotactic radiosurgery

Authors: Putipun Puataweepong, Mantana Dhanachai, Ake Hansasuta, Somjai Dangprasert, Chomporn Sitathanee, Rawee Ruangkanchanasetr, Pornpan Yongvithisatid

Published in: Journal of Neuro-Oncology | Issue 3/2018

Login to get access

Abstract

Introduction

Stereotactic radiation technique is widely reported as an effective treatment for various types of benign intracranial tumors. However, single fraction radiosurgery (SRS) is not recommended for tumors located close to the optic apparatus due to the restricted radiation tolerance dose of the optic pathway. Recent advances in radiotherapy include advanced frameless radiosurgery using hypofractionated stereotactic radiotherapy (HSRT), and this has become an attractive treatment option for perioptic tumors within 2–3 mm of the optic pathway. Accordingly, the aim of this study was to investigate the clinical outcomes of perioptic tumors treated with HSRT using CyberKnife® (CK) robotic radiosurgery system relative to tumor control, vision preservation and toxicity.

Methods

This retrospective analysis of prospectively collected data included consecutive 100 patients that were diagnosed with and treated for perioptic tumor at the Radiosurgery center, Ramathibodi Hospital during the January 2009 to December 2012 study period.

Results

The median tumor volume was 6.81 cm3 (range 0.37–51.6), and the median prescribed dose was 25 Gy (range 20–35) in 5 fractions (range 3–5). After the median follow-up time of 37.5 months (range 21–103), two patients developed tumor progression at 6 and 34 months post-HSRT. The 5-year overall survival was 97%, and the 5-year local control was 97.5%. At the last follow-up, no vision deterioration or newly developed hypopituitarism was detected in our study.

Conclusions

Although a longer follow-up is needed, HSRT yields a high level of local control and vision preservation, and should be considered a treatment of choice for perioptic tumor located close to the optic apparatus.
Literature
1.
go back to reference Eisenhauer EA, Therasse P, Bogarerts J et al (2008) New response evaluation criteria in solid tumors: revised RECIST guideline. Eur J Cancer 45:228–247CrossRef Eisenhauer EA, Therasse P, Bogarerts J et al (2008) New response evaluation criteria in solid tumors: revised RECIST guideline. Eur J Cancer 45:228–247CrossRef
2.
go back to reference Kalapurakal JA (2005) Radiation therapy in the management of pediatric craniopharyngiomas: a review. Childs Nerv Syst 21(8–9):808–816CrossRefPubMed Kalapurakal JA (2005) Radiation therapy in the management of pediatric craniopharyngiomas: a review. Childs Nerv Syst 21(8–9):808–816CrossRefPubMed
3.
go back to reference Flickinger JC, Kondziolka D, Maitz AH, Lunsford LD (2003) Gamma knife radiosurgery of imaging-diagnosed intracranial meningioma. Int J Radiat Oncol Biol Phys 56(3):801–806CrossRefPubMed Flickinger JC, Kondziolka D, Maitz AH, Lunsford LD (2003) Gamma knife radiosurgery of imaging-diagnosed intracranial meningioma. Int J Radiat Oncol Biol Phys 56(3):801–806CrossRefPubMed
4.
go back to reference Stafford SL, Pollock BE, Foote RL et al (2001) Meningioma radiosurgery: tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery 49(5):1029–1037 (discussion 37–8)PubMed Stafford SL, Pollock BE, Foote RL et al (2001) Meningioma radiosurgery: tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery 49(5):1029–1037 (discussion 37–8)PubMed
5.
go back to reference Girkin CA, Comey CH, Lunsford LD, Goodman ML, Kline LB (1997) Radiation optic neuropathy after stereotactic radiosurgery. Ophthalmology 104(10):1634–1643CrossRefPubMed Girkin CA, Comey CH, Lunsford LD, Goodman ML, Kline LB (1997) Radiation optic neuropathy after stereotactic radiosurgery. Ophthalmology 104(10):1634–1643CrossRefPubMed
6.
go back to reference Tishler RB, Loeffler JS, Lunsford LD et al (1993) Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 27(2):215–221CrossRefPubMed Tishler RB, Loeffler JS, Lunsford LD et al (1993) Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiat Oncol Biol Phys 27(2):215–221CrossRefPubMed
7.
go back to reference Fokas E, Henzel M, Surber G, Hamm K, Engenhart-Cabillic R (2014) Stereotactic radiation therapy for benign meningioma: long-term outcome in 318 patients. Int J Radiat Oncol Biol Phys 89(3):569–575CrossRefPubMed Fokas E, Henzel M, Surber G, Hamm K, Engenhart-Cabillic R (2014) Stereotactic radiation therapy for benign meningioma: long-term outcome in 318 patients. Int J Radiat Oncol Biol Phys 89(3):569–575CrossRefPubMed
8.
go back to reference Solda F, Wharram B, De Ieso PB et al (2013) Long-term efficacy of fractionated radiotherapy for benign meningiomas. Radiother Oncol 109(2):330–334CrossRefPubMed Solda F, Wharram B, De Ieso PB et al (2013) Long-term efficacy of fractionated radiotherapy for benign meningiomas. Radiother Oncol 109(2):330–334CrossRefPubMed
9.
go back to reference Stiebel-Kalish H, Reich E, Gal L et al (2012) Visual outcome in meningiomas around anterior visual pathways treated with linear accelerator fractionated stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 82(2):779–788CrossRefPubMed Stiebel-Kalish H, Reich E, Gal L et al (2012) Visual outcome in meningiomas around anterior visual pathways treated with linear accelerator fractionated stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 82(2):779–788CrossRefPubMed
10.
go back to reference Barber SM, Teh BS, Baskin DS (2016) Fractionated stereotactic radiotherapy for pituitary adenomas: single-center experience in 75 consecutive patients. Neurosurgery 79(3):406–417CrossRefPubMed Barber SM, Teh BS, Baskin DS (2016) Fractionated stereotactic radiotherapy for pituitary adenomas: single-center experience in 75 consecutive patients. Neurosurgery 79(3):406–417CrossRefPubMed
11.
go back to reference Kim JO, Ma R, Akagami R et al (2013) Long-term outcomes of fractionated stereotactic radiation therapy for pituitary adenomas at the BC Cancer Agency. Int J Radiat Oncol Biol Phys 87(3):528–533CrossRefPubMed Kim JO, Ma R, Akagami R et al (2013) Long-term outcomes of fractionated stereotactic radiation therapy for pituitary adenomas at the BC Cancer Agency. Int J Radiat Oncol Biol Phys 87(3):528–533CrossRefPubMed
12.
go back to reference Harrabi SB, Adeberg S, Welzel T et al (2014) Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma: maximal tumor control with minimal side effects. Radiat Oncol 9:203CrossRefPubMedPubMedCentral Harrabi SB, Adeberg S, Welzel T et al (2014) Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma: maximal tumor control with minimal side effects. Radiat Oncol 9:203CrossRefPubMedPubMedCentral
13.
go back to reference Conti A, Pontoriero A, Midili F et al (2015) CyberKnife multisession stereotactic radiosurgery and hypofractionated stereotactic radiotherapy for perioptic meningiomas: intermediate-term results and radiobiological considerations. Springerplus 4:37CrossRefPubMedPubMedCentral Conti A, Pontoriero A, Midili F et al (2015) CyberKnife multisession stereotactic radiosurgery and hypofractionated stereotactic radiotherapy for perioptic meningiomas: intermediate-term results and radiobiological considerations. Springerplus 4:37CrossRefPubMedPubMedCentral
14.
go back to reference Adler JR Jr, Gibbs IC, Puataweepong P, Chang SD (2006) Visual field preservation after multisession cyberknife radiosurgery for perioptic lesions. Neurosurgery 59(2):244–254 (discussion 254)CrossRefPubMed Adler JR Jr, Gibbs IC, Puataweepong P, Chang SD (2006) Visual field preservation after multisession cyberknife radiosurgery for perioptic lesions. Neurosurgery 59(2):244–254 (discussion 254)CrossRefPubMed
15.
go back to reference Metellus P, Regis J, Muracciole X et al (2005) Evaluation of fractionated radiotherapy and gamma knife radiosurgery in cavernous sinus meningiomas: treatment strategy. Neurosurgery 57(5):873–886CrossRefPubMed Metellus P, Regis J, Muracciole X et al (2005) Evaluation of fractionated radiotherapy and gamma knife radiosurgery in cavernous sinus meningiomas: treatment strategy. Neurosurgery 57(5):873–886CrossRefPubMed
16.
go back to reference Adler JR Jr, Gibbs IC, Puataweepong P, Chang SD (2008) Visual field preservation after multisession cyberknife radiosurgery for perioptic lesions. Neurosurgery 62(Suppl 2):733–743PubMed Adler JR Jr, Gibbs IC, Puataweepong P, Chang SD (2008) Visual field preservation after multisession cyberknife radiosurgery for perioptic lesions. Neurosurgery 62(Suppl 2):733–743PubMed
17.
go back to reference Kim JW, Im YS, Nam DH et al (2008) Preliminary report of multisession gamma knife radiosurgery for benign perioptic lesions: visual outcome in 22 patients. J Korean Neurosurg Soc 44(2):67–71CrossRefPubMedPubMedCentral Kim JW, Im YS, Nam DH et al (2008) Preliminary report of multisession gamma knife radiosurgery for benign perioptic lesions: visual outcome in 22 patients. J Korean Neurosurg Soc 44(2):67–71CrossRefPubMedPubMedCentral
18.
go back to reference Killory BD, Kresl JJ, Wait SD et al (2009) Hypofractionated CyberKnife radiosurgery for perichiasmatic pituitary adenomas: early results. Neurosurgery 64(2 Suppl):A19–A25CrossRefPubMed Killory BD, Kresl JJ, Wait SD et al (2009) Hypofractionated CyberKnife radiosurgery for perichiasmatic pituitary adenomas: early results. Neurosurgery 64(2 Suppl):A19–A25CrossRefPubMed
19.
go back to reference Jee TK, Seol HJ, Im YS, Kong DS et al (2014) Fractionated gamma knife radiosurgery for benign perioptic tumors: outcomes of 38 patients in a single institute. Brain Tumor Res Treat 2(2):56–61CrossRefPubMedPubMedCentral Jee TK, Seol HJ, Im YS, Kong DS et al (2014) Fractionated gamma knife radiosurgery for benign perioptic tumors: outcomes of 38 patients in a single institute. Brain Tumor Res Treat 2(2):56–61CrossRefPubMedPubMedCentral
20.
go back to reference Liao HI, Wang CC, Wei KC et al (2014) Fractionated stereotactic radiosurgery using the Novalis system for the management of pituitary adenomas close to the optic apparatus. J Clin Neurosci 21(1):111–115CrossRefPubMed Liao HI, Wang CC, Wei KC et al (2014) Fractionated stereotactic radiosurgery using the Novalis system for the management of pituitary adenomas close to the optic apparatus. J Clin Neurosci 21(1):111–115CrossRefPubMed
21.
go back to reference Puataweepong P, Dhanachai M, Hansasuta A et al (2016) The clinical outcome of hypofractionated stereotactic radiotherapy with CyberKnife robotic radiosurgery for perioptic pituitary adenoma. Technol Cancer Res Treat 15(6):Np10–NP15CrossRefPubMed Puataweepong P, Dhanachai M, Hansasuta A et al (2016) The clinical outcome of hypofractionated stereotactic radiotherapy with CyberKnife robotic radiosurgery for perioptic pituitary adenoma. Technol Cancer Res Treat 15(6):Np10–NP15CrossRefPubMed
22.
go back to reference Lee EJ, Cho YH, Yoon K et al (2017) Radiosurgical decompression for benign perioptic tumors causing compressive cranial neuropathies: a feasible alternative to microsurgery? J Neurooncol 131(1):73–81CrossRefPubMed Lee EJ, Cho YH, Yoon K et al (2017) Radiosurgical decompression for benign perioptic tumors causing compressive cranial neuropathies: a feasible alternative to microsurgery? J Neurooncol 131(1):73–81CrossRefPubMed
24.
go back to reference Leavitt JA, Stafford SL, Link MJ et al (2013) Long term evaluation of radiation-induced optic neuropathy after single-fraction stereoatctic radiosurgery. Int J Radiat Oncol Biol Phys 87:524–527CrossRefPubMed Leavitt JA, Stafford SL, Link MJ et al (2013) Long term evaluation of radiation-induced optic neuropathy after single-fraction stereoatctic radiosurgery. Int J Radiat Oncol Biol Phys 87:524–527CrossRefPubMed
25.
go back to reference Pollock BE, Link MJ, Leavitt JA et al (2014) Dose-volume analysis of radiation-induced optic neuropathy after single-fraction stereotactic radiosurgery. Neurosurgery 75:456–460CrossRefPubMed Pollock BE, Link MJ, Leavitt JA et al (2014) Dose-volume analysis of radiation-induced optic neuropathy after single-fraction stereotactic radiosurgery. Neurosurgery 75:456–460CrossRefPubMed
26.
go back to reference Mayo C, Martel MK, Marks LB et al (2010) Radiation dose-volume effects of optic nerves and chiasm. Int J Radiat Oncol Biol Phys 76(3 Suppl):S28–S35CrossRefPubMed Mayo C, Martel MK, Marks LB et al (2010) Radiation dose-volume effects of optic nerves and chiasm. Int J Radiat Oncol Biol Phys 76(3 Suppl):S28–S35CrossRefPubMed
27.
go back to reference Romanelli P, Wowra B, Muacevic A (2007) Multisession CyberKnife radiosurgery for optic nerve sheath meningiomas. Neurosurg Focus 23(6):E11CrossRefPubMed Romanelli P, Wowra B, Muacevic A (2007) Multisession CyberKnife radiosurgery for optic nerve sheath meningiomas. Neurosurg Focus 23(6):E11CrossRefPubMed
28.
go back to reference Colombo F, Casentini L, Cavedon C et al (2009) Cyberknife radiosurgery for benign meningiomas: short-term results in 199 patients. Neurosurgery 64(2 Suppl):A7–A13CrossRefPubMed Colombo F, Casentini L, Cavedon C et al (2009) Cyberknife radiosurgery for benign meningiomas: short-term results in 199 patients. Neurosurgery 64(2 Suppl):A7–A13CrossRefPubMed
29.
go back to reference Marchetti M, Bianchi S, Milanesi I et al (2011) Multisession radiosurgery for optic nerve sheath meningiomas: an effective option: preliminary results of a single-center experience. Neurosurgery 69(5):1116–1122 (discussion 22–3)PubMed Marchetti M, Bianchi S, Milanesi I et al (2011) Multisession radiosurgery for optic nerve sheath meningiomas: an effective option: preliminary results of a single-center experience. Neurosurgery 69(5):1116–1122 (discussion 22–3)PubMed
31.
go back to reference Tanaka S, Link MJ, Brown PD et al (2010) Gamma knife radiosurgery for patients with prolactin-secreting pituitary adenomas. World Neurosurg 74(1):147–152CrossRefPubMed Tanaka S, Link MJ, Brown PD et al (2010) Gamma knife radiosurgery for patients with prolactin-secreting pituitary adenomas. World Neurosurg 74(1):147–152CrossRefPubMed
32.
go back to reference Grant RA, Whicker M, Lleva R et al (2014) Efficacy and safety of higher dose stereotactic radiosurgery for functional pituitary adenomas: a preliminary report. World Neurosurg 82(1–2):195–201CrossRefPubMed Grant RA, Whicker M, Lleva R et al (2014) Efficacy and safety of higher dose stereotactic radiosurgery for functional pituitary adenomas: a preliminary report. World Neurosurg 82(1–2):195–201CrossRefPubMed
33.
go back to reference Lee CC, Vance ML, Xu Z et al (2014) Stereotactic radiosurgery for acromegaly. J Clin Endocrinol Metab 99(4):1273–1281CrossRefPubMed Lee CC, Vance ML, Xu Z et al (2014) Stereotactic radiosurgery for acromegaly. J Clin Endocrinol Metab 99(4):1273–1281CrossRefPubMed
34.
go back to reference Weber DC, Momjian S, Pralong FP et al (2011) Adjuvant or radical fractionated stereotactic radiotherapy for patients with pituitary functional and nonfunctional macroadenoma. Radiat Oncol 6:169CrossRefPubMedPubMedCentral Weber DC, Momjian S, Pralong FP et al (2011) Adjuvant or radical fractionated stereotactic radiotherapy for patients with pituitary functional and nonfunctional macroadenoma. Radiat Oncol 6:169CrossRefPubMedPubMedCentral
35.
go back to reference Yan JL, Chang CN, Chuang CC et al (2013) Long-term follow-up of patients with surgical intractable acromegaly after linear accelerator radiosurgery. J Formos Med Assoc 112(7):416–420CrossRefPubMed Yan JL, Chang CN, Chuang CC et al (2013) Long-term follow-up of patients with surgical intractable acromegaly after linear accelerator radiosurgery. J Formos Med Assoc 112(7):416–420CrossRefPubMed
36.
go back to reference Wilson PJ, De-Loyde KJ, Williams JR, Smee RI (2013) Acromegaly: a single centre’s experience of stereotactic radiosurgery and radiotherapy for growth hormone secreting pituitary tumours with the linear accelerator. J Clin Neurosci 20(11):1506–1513CrossRefPubMed Wilson PJ, De-Loyde KJ, Williams JR, Smee RI (2013) Acromegaly: a single centre’s experience of stereotactic radiosurgery and radiotherapy for growth hormone secreting pituitary tumours with the linear accelerator. J Clin Neurosci 20(11):1506–1513CrossRefPubMed
37.
go back to reference Castinetti F, Brue T (2009) Radiotherapy and radiosurgery of pituitary adenomas. Presse Med 38(1):133–139CrossRefPubMed Castinetti F, Brue T (2009) Radiotherapy and radiosurgery of pituitary adenomas. Presse Med 38(1):133–139CrossRefPubMed
38.
go back to reference Puataweepong P, Dhanachai M, Dangprasert S et al (2009) Comparison of conventional external radiotherapy and stereotactic radiotherapy in the treatment of pituitary adenoma. J Med Assoc Thai 92(3):382–389PubMed Puataweepong P, Dhanachai M, Dangprasert S et al (2009) Comparison of conventional external radiotherapy and stereotactic radiotherapy in the treatment of pituitary adenoma. J Med Assoc Thai 92(3):382–389PubMed
Metadata
Title
Clinical outcomes of perioptic tumors treated with hypofractionated stereotactic radiotherapy using CyberKnife® stereotactic radiosurgery
Authors
Putipun Puataweepong
Mantana Dhanachai
Ake Hansasuta
Somjai Dangprasert
Chomporn Sitathanee
Rawee Ruangkanchanasetr
Pornpan Yongvithisatid
Publication date
01-09-2018
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 3/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-018-2913-6

Other articles of this Issue 3/2018

Journal of Neuro-Oncology 3/2018 Go to the issue