Acute Management of Gamma Knife Radiosurgery for Asymptomatic Obstructive Hydrocephalus Associated with Posterior Fossa Metastases
| Autor: | Shigeo Matsunaga, Hidetoshi Murata, Takashi Shuto, Takashi Yamamoto, Natsuki Kobayashi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Posterior fossa Gamma knife radiosurgery Radiosurgery Asymptomatic Skull Base Neoplasms Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Postoperative Complications Medicine Humans Aged Gastrointestinal Neoplasms Retrospective Studies Aged 80 and over Gastrointestinal tract business.industry Medical record Incidence Cancer Middle Aged medicine.disease Magnetic Resonance Imaging Hydrocephalus Treatment Outcome Cranial Fossa Posterior Tumor progression 030220 oncology & carcinogenesis Surgery Female Neurology (clinical) Radiology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 144 |
| ISSN: | 1878-8769 |
| Popis: | We retrospectively assessed the effectiveness and safety of Gamma Knife radiosurgery (GKRS) for asymptomatic obstructive hydrocephalus associated with posterior fossa metastases, which was known empirically but not well discussed.We reviewed the medical records of 27 patients who underwent GKRS for asymptomatic obstructive hydrocephalus related to posterior fossa metastases.Cumulative control rates of hydrocephalus were 11.1%, 51.9%, 70.4%, and 74.6% at 1, 2, 3, and 6 months after GKRS. Primary gastrointestinal tract cancer (P = 0.001) was significantly correlated with unfavorable management. Evans ratio at GKRS (median 0.31) improved significantly compared with that at 1-3 months after GKRS (median 0.26) (P0.0001) and maintained at 6 to 12 months. Cumulative local tumor control rates were 91.7%, 70.8%, and 64.4% at 3, 6, and 12 months after GKRS. Primary gastrointestinal tract cancer (P = 0.018) and no conventional systemic agents (P = 0.027) were significantly correlated with unfavorable control. Cumulative incidence rates of adverse radiation effects were 0.0%, 16.7%, and 24.2% at 6, 9, and 12 months after GKRS. Primary gastrointestinal tract cancer (P0.0001) and single and 2- or 3-fraction GKRS (P0.0001) were significantly correlated with unfavorable outcomes. All but 1 patient avoided surgical procedure for hydrocephalus after GKRS.The present findings suggest that GKRS is an effective and safe treatment for asymptomatic obstructive hydrocephalus caused by posterior fossa metastases, and all but 1 could avoid invasive surgical procedures for hydrocephalus. Posterior fossa metastases from gastrointestinal tract cancer resulted in unsatisfactory outcomes for control of hydrocephalus, tumor progression, and adverse radiation effects. |
| Databáze: | OpenAIRE |
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