Gamma Knife surgery for low-grade astrocytomas: evaluation of long-term outcome based on a 10-year experience.

Ling Wei Wang, Cheng Ying Shiau, Wen Yuh Chung, Hsiu Mei Wu, Wan Yuo Guo, Kang Du Liu, Donald Ming Tak Ho, Tai-Tong Wong, David Hung Chi Pan

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22 Citations (Scopus)

Abstract

OBJECT: The authors report the long-term treatment results of Gamma Knife surgery (GKS) for patients with low-grade astrocytomas who underwent surgery at a single institution. METHODS: A series of 21 patients (median age 20 years) with 25 intracranial low-grade astrocytomas (World Health Organization Grades I and II) were treated with GKS between 1993 and 2003. Among them, four underwent GKS as a primary treatment. Two underwent GKS as a treatment boost after radiotherapy. In the other 15 patients, GKS was performed as an adjuvant or salvage treatment for residual/recurrent tumors after the patients had undergone craniotomy. Tumor volumes ranged from 0.2 to 13.3 ml (median 2.4 ml). Prescription margin doses ranged from 8 to 18 Gy (median 14.5 Gy). Radiation volumes were 1.3 to 21.6 ml (median 3.6 ml). Patients underwent regular follow up, with neurological evaluation and magnetic resonance imaging studies obtained at 6-month intervals. One patient was lost to follow-up. The clinical follow-up time was 5 to 144 months (median 67 months). Complete tumor remission was seen in three patients. The 10-year progression-free patient survival rate after GKS was 65%. Tumor progression was found in six patients of whom five received further salvage treatment. All the tumor progression occurred within the GKS-treated volumes. Mild-to-moderate adverse radiation effects (AREs) were found in eight patients. Both of the patients who had undergone GKS as a treatment boost after radiotherapy developed AREs, but with good shrinkage of tumors. CONCLUSIONS: Gamma Knife surgery provides durable long-term local tumor control with acceptable toxicity for some patients with highly selected low-grade astrocytomas.

Original languageEnglish
Pages (from-to)127-132
Number of pages6
JournalJournal of Neurosurgery
Volume105 Suppl
Publication statusPublished - Dec 1 2006
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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    Wang, L. W., Shiau, C. Y., Chung, W. Y., Wu, H. M., Guo, W. Y., Liu, K. D., Ho, D. M. T., Wong, T-T., & Pan, D. H. C. (2006). Gamma Knife surgery for low-grade astrocytomas: evaluation of long-term outcome based on a 10-year experience. Journal of Neurosurgery, 105 Suppl, 127-132.