Gamma knife surgery for subependymal giant cell astrocytomas: Clinical article

Kyung Jae Park, Hideyuki Kano, Douglas Kondziolka, Ajay Niranjan, John C. Flickinger, L. Dade Lunsford

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)

Abstract

Object. The authors report their experience of using Gamma Knife surgery (GKS) in patients with subependymal giant cell astrocytoma (SEGA). Methods. Over a 20-year period, the authors identified 6 patients with SEGAs who were eligible for GKS. The median patient age was 16.5 years (range 7-55 years). In 4 patients, GKS was used as a primary management therapy. One patient underwent radiosurgery for recurrent tumors after prior resection, and in 1 patient GKS was used as an adjunct after subtotal resection. The median tumor volume at GKS was 2.75 cm3 (range 0.7-5.9 cm3). A median radiation dose of 14 Gy (range 11-20 Gy) was delivered to the tumor margin. Results. The median follow-up duration was 73 months (range 42-90 months). Overall local tumor control was achieved in 4 tumors (67%) with progression-free periods of 24, 42, 57, and 66 months. Three tumors regressed and one remained unchanged. In 2 patients the tumors progressed, and in 1 of these patients the lesion was managed by repeated GKS with subsequent tumor regression. The other relatively large tumor (5.9 cm3) was excised 9 months after GKS. The progression-free period for all GKS-managed tumors varied from 9 to 66 months. There were no cases of hydrocephalus or GKS-related morbidity. Conclusions. Gamma Knife surgery may be an additional minimally invasive management option for SEGA in a patient who harbors a small but progressively enlarging tumor when complete resection is not safely achievable. It may also benefit patients with a residual or recurrent tumor that has progressed after surgery.

Original languageEnglish
Pages (from-to)808-813
Number of pages6
JournalJournal of Neurosurgery
Volume114
Issue number3
DOIs
Publication statusPublished - 2011 Mar
Externally publishedYes

Keywords

  • Gamma knife surgery
  • Glioma
  • Radiosurgery
  • Subependymal giant cell astrocytoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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