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01-10-2018 | Clinical Study

Optimal strategy of gamma knife radiosurgery for craniopharyngiomas

Authors: Yun-Sik Dho, Yong Hwy Kim, Jin Wook Kim, Chul-Kee Park, Hyun-Tai Chung, Seung-Ki Kim, Sun Ha Paek, Kyu-Chang Wang, Dong Gyu Kim

Published in: Journal of Neuro-Oncology | Issue 1/2018

Abstract

Object

To analyze the outcomes of gamma knife radiosurgery (GKS) for craniopharyngiomas and elucidate the optimal strategy.

Methods

Between 1998 and 2016, 35 patients underwent GKS for the treatment of 40 recurrent or residual craniopharyngiomas. Among 40 GKSs, 22 procedures were single-session GKSs and 18 procedures were fractionated GKSs. In cases of single-session GKS, the median marginal dose was 15 Gy (range 10–20 Gy). In cases of fractionated GKS, the median marginal dose was 6 Gy (range 5–7.5 Gy) of three fractions. The radiation dose was calculated to the biologic equivalent dose (BED) using α/β ratios of 10 and 2.

Result

The location of the tumor, the distance between the optic nerve and tumor (> 10 mm), BED 10 (> 35 Gy), and BED2 (> 80 Gy) were statistically significant with overall response rate (P = 0.008, 0.02, 0.03, and 0.002, respectively). There was a statistically significant difference in progression-free survival according to the distance between the optic nerve and tumor (> 10 mm) and the location of tumor (P = 0.03 and 0.03, respectively). Multivariate logistic regression analysis showed the hypothalamus group had an odds ratio of 0.04 compared with the suprasellar group for tumor progression. The group with BED2 > 80 Gy had an odds ratio of 0.049 compared with the group with BED2 < 80 Gy.

Conclusion

A sufficient dose is required for treating craniopharyngiomas using single-session and fractionated GKS. The outcomes of GKS can be predicted according to the location of tumor, the distance between the optic nerve and tumor and BED value.

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Title: Optimal strategy of gamma knife radiosurgery for craniopharyngiomas
Authors: Yun-Sik Dho
Yong Hwy Kim
Jin Wook Kim
Chul-Kee Park
Hyun-Tai Chung
Seung-Ki Kim
Sun Ha Paek
Kyu-Chang Wang
Dong Gyu Kim
Publication date: 01-10-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 1/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2943-0

At a glance: The STEP trials

Springer Medicine

Optimal strategy of gamma knife radiosurgery for craniopharyngiomas

Abstract

Object

Methods

Result

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Object

Methods

Result

Conclusion

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