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

Research output: Contribution to journalArticle

21 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

Fingerprint

Astrocytoma
Salvage Therapy
Radiation Effects
Neoplasms
Radiotherapy
Craniotomy
Lost to Follow-Up
Residual Neoplasm
Therapeutics
Tumor Burden
Disease-Free Survival
Prescriptions
Survival Rate
Magnetic Resonance Imaging
Radiation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Wang, L. W., Shiau, C. Y., Chung, W. Y., Wu, H. M., Guo, W. Y., Liu, K. D., ... 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.

Gamma Knife surgery for low-grade astrocytomas : evaluation of long-term outcome based on a 10-year experience. / Wang, Ling Wei; Shiau, Cheng Ying; Chung, Wen Yuh; Wu, Hsiu Mei; Guo, Wan Yuo; Liu, Kang Du; Ho, Donald Ming Tak; Wong, Tai-Tong; Pan, David Hung Chi.

In: Journal of Neurosurgery, Vol. 105 Suppl, 01.12.2006, p. 127-132.

Research output: Contribution to journalArticle

Wang, LW, Shiau, CY, Chung, WY, Wu, HM, Guo, WY, Liu, KD, Ho, DMT, Wong, T-T & Pan, DHC 2006, 'Gamma Knife surgery for low-grade astrocytomas: evaluation of long-term outcome based on a 10-year experience.', Journal of Neurosurgery, vol. 105 Suppl, pp. 127-132.
Wang LW, Shiau CY, Chung WY, Wu HM, Guo WY, Liu KD et al. Gamma Knife surgery for low-grade astrocytomas: evaluation of long-term outcome based on a 10-year experience. Journal of Neurosurgery. 2006 Dec 1;105 Suppl:127-132.
Wang, Ling Wei ; Shiau, Cheng Ying ; Chung, Wen Yuh ; Wu, Hsiu Mei ; Guo, Wan Yuo ; Liu, Kang Du ; Ho, Donald Ming Tak ; Wong, Tai-Tong ; Pan, David Hung Chi. / Gamma Knife surgery for low-grade astrocytomas : evaluation of long-term outcome based on a 10-year experience. In: Journal of Neurosurgery. 2006 ; Vol. 105 Suppl. pp. 127-132.
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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.",
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AU - Wu, Hsiu Mei

AU - Guo, Wan Yuo

AU - Liu, Kang Du

AU - Ho, Donald Ming Tak

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N2 - 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.

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