チエルノフ ミハイル
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Gamma knife radiosurgery for benign cavernous sinus tumors: treatment concept and outcomes in 120 cases.
Journal Formal name:Neurologia medico-chirurgica
Abbreviation:Neurol Med Chir (Tokyo)
ISSN code:13498029(Electronic)04708105(Linking)
Volume, Issue, Page 52(10),pp.714-723
Author and coauthor HAYASHI Motohiro†, CHERNOV Mikhail, TAMURA Noriko, TAMURA Manabu, MATSUOKA Ayako, KONISHI Yoshiyuki, OKADA Yoshikazu, ISEKI Hiroshi, TAKAKURA Kintomo
Publication date 2012/10
Summary 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
Document No. 095263