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Acta Neurochirurgica

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01-12-2024 | Metastasis | Original Article

Is two-staged gamma knife surgery a reasonable management option for very large cerebellar metastases? A case series of three patients

Authors: Yu Tung Lo, Bengt Karlsson, Andrea Wong, Balamurugan A. Vellayappan, Tseng Tsai Yeo, Vincent Diong Weng Nga

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Objective

Two-staged gamma knife surgery (GKS) is a method that may extend the upper tumor volume limit for using GKS in the management of brain metastases. However, the safety of treating very large posterior fossa lesions with this technique has not been well demonstrated. Therefore, we analyzed our experience in treating cerebellar metastases larger than 12 cm³ with two-staged GKS.

Methods

Four consecutive patients harboring 12 to 30 cm³ cerebellar metastases scheduled two-staged GKS were included in the study, and all but one patient completed the treatment. The treatment doses were 10–13 Gy. All patients were followed with regular MR imaging and clinical assessments, and the tumor volumes were measured on all treatment and follow-up images.

Results

Tumor progression was not demonstrated in any of the patients. Tumor volumes decreased by, on average, more than half between the two stages. The median survival was 22 months, and no patient died due to intracranial tumor progression. Peritumoral edema at the first GKS resolved in all patients, replaced by asymptomatic mild T2 changes in two of them not requiring any treatment. No radiation-induced complication has developed thus far.

Conclusion

Staged GKS seems to be a feasible management option for very large cerebellar metastases.

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Title: Is two-staged gamma knife surgery a reasonable management option for very large cerebellar metastases? A case series of three patients
Authors: Yu Tung Lo
Bengt Karlsson
Andrea Wong
Balamurugan A. Vellayappan
Tseng Tsai Yeo
Vincent Diong Weng Nga
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Metastasis
Edema
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-05974-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is two-staged gamma knife surgery a reasonable management option for very large cerebellar metastases? A case series of three patients

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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