イセキ　ヒロシ   Iseki Hiroshi   伊関　洋    所属   医学研究科 医学研究科 (医学部医学科をご参照ください)    職種   特任顧問
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Gamma knife radiosurgery for benign cavernous sinus tumors: treatment concept and outcomes in 120 cases.
掲載誌名	正式名：Neurologia medico-chirurgica 略　 称：Neurol Med Chir (Tokyo) ISSNコード：13498029(Electronic)04708105(Linking)
巻・号・頁	52(10),pp.714-723
著者・共著者	HAYASHI Motohiro†, CHERNOV Mikhail, TAMURA Noriko, TAMURA Manabu, MATSUOKA Ayako, KONISHI Yoshiyuki, OKADA Yoshikazu, ISEKI Hiroshi, TAKAKURA Kintomo
発行年月	2012/10
概要	Availability of modern computer-aided robotized devices, such as the Automatic Positioning System (APS(TM); Elekta Instruments AB, Stockholm, Sweden) and Perfexion(TM) (Elekta Instruments AB), allowed us to develop the original concept of robotic gamma knife microradiosurgery, which is based on the very precise irradiation of the lesion with regard to conformity and selectivity; intentional avoidance of the excessive irradiation of functionally-important anatomical structures, particularly cranial nerves, located both within and in the vicinity of the target; and delivery of sufficient irradiation energy to the tumor with the intention to attain lesion shrinkage, while keeping the marginal dose sufficiently low for prevention of possible complications. The results of such treatment strategy were evaluated retrospectively in 120 patients with benign cavernous sinus neoplasms (pituitary adenomas, meningiomas, schwannomas, and hemangiomas), who were followed up from 24 to 78 months (mean 47 months) after radiosurgery. Tumor growth control and shrinkage rates were 98% and 68%, respectively. More than 50% volume reduction was noted in 25% of lesions. The most prominent volumetric tumor response was observed in hemangiomas, followed by schwannomas, pituitary adenomas, and meningiomas. Treatment-related complications were marked in 7% of cases, and were mainly related to transient isolated cranial neuropathy appearing within several months after radiosurgery. Major morbidity was limited to one patient (0.8%). Application of microradiosurgical treatment principles provides effective and safe management of benign cavernous sinus tumors and is associated with high probability of lesion shrinkage and minimal risk of complications.
DOI	10.2176/nmc.52.714
文献番号	095263