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Acta Neurochirurgica
Published in: Acta Neurochirurgica 2/2015

01-02-2015 | Clinical Article - Brain Tumors

Gamma Knife radiosurgery for low-grade tectal gliomas

Authors: Amr Mohamed Nageeb El-Shehaby, Wael Abdel Halim Reda, Khaled Mohamed Abdel Karim, Reem Mohamed Emad Eldin, Ignatius Ngene Esene

Published in: Acta Neurochirurgica | Issue 2/2015

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Abstract

Background

Tectal gliomas are present in a critical location that makes their surgical treatment difficult. Stereotactic radiosurgery presents an attractive noninvasive treatment option. However, tectal gliomas are also commonly associated with aqueductal obstruction and consequently hydrocephalus. This necessitates some form of CSF diversion procedure before radiosurgery. The aim of the study was to assess the efficacy and safety of Gamma Knife radiosurgery for tectal gliomas.

Patients and methods

Between October 2002 and May 2011, 11 patients with tectal gliomas were treated with Gamma Knife radiosurgery. Five patients had pilocytic astrocytomas and six nonpilocytic astrocytomas. Ten patients presented with hydrocephalus and underwent a CSF diversion procedure [7 V-P shunt and 3 endoscopic third ventriculostomy (ETV)]. The tumor volume ranged between 1.2–14.7 cc (median 4.5 cc). The prescription dose was 11–14 Gy (median 12 Gy).

Results

Patients were followed for a median of 40 months (13–114 months). Tumor control after radiosurgery was seen in all cases. In 6/11 cases, the tumors eventually disappeared after treatment. Peritumoral edema developed in 5/11 cases at an onset of 3–6 months after treatment. Transient tumor swelling was observed in four cases. Four patients developed cysts after treatment. One of these cases required aspiration and eventually disappeared, one became smaller spontaneously, and two remained stable.

Conclusion

Gamma Knife radiosurgery is an effective and safe technique for treatment of tectal gliomas. Tumor shrinkage or disappearance after Gamma Knife radiosurgery may preclude the need for a shunt later on.
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Metadata
Title
Gamma Knife radiosurgery for low-grade tectal gliomas
Authors
Amr Mohamed Nageeb El-Shehaby
Wael Abdel Halim Reda
Khaled Mohamed Abdel Karim
Reem Mohamed Emad Eldin
Ignatius Ngene Esene
Publication date
01-02-2015
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 2/2015
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-014-2299-y

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