GAMMA KNIFE RADIOSURGERY FOR MIDLINE LESIONS
1998 年 48 巻 Special1 号 p. 41-50
詳細
1998 年 48 巻 Special1 号 p. 41-50
Surgery of midline lesions is difficult in many cases and often only partial removal is possible. Between May 1992 and April 1997, 81 patients with midline lesions were treated radiosurgically. The lesions were located in the hypothalamic region (25), thalamus (20), third ventricle (2), quadrigeminal plate (9), pons (13), fourth ventricle (4), pineal region (4) and other locations (4). Forty-eight patients were male and 33 were female. Histologically, there were 56 benign cases (13 arteriovenous malformations, 11 low grade gliomas, 20 craniopharyngiomas, 5 meningiomas, 3 hamartomas, 4 miscellaneous) and 25 malignant cases (10 metastases, 10 high grade gliomas, 2 medulloblastomas, 3 miscellaneous). Clinical and radiological follow-up was obtained in 71 patients (88%). In all patients the treatment was well tolerated. Radiographic response could be achieved in 39 of 68 tumor patients (57%). A complete obliteration was seen in 6 arteriovenous malformations (60%) 2 years after radiosurgery. A second radio-surgical procedure was necessary in 2 patients because of incomplete obliteration after 3 years. According to our experience, we can conclude that radiosurgery appears to be effective as adjuvant treatment of midline lesions.
