Plenary Oral Presentations - Macquarie University Hospital

More documents

Recommendations

Info

16 th International Meeting of the Leksell Gamma Knife ® SocietyMarch 2012, Sydney, AustraliaBE-163Beyond the ten thousand: experiences ofthe Sheffield Gamma Knife unitAndras Kemeny, Matthias Radatz, Jeremy RoweNational Centre For Stereotactic Radiosurgery, SheffieldObjective: Review of 25 year experience with Gamma Knife technology.Methods: Since its installation in 1985 the Gamma Knife unit in Sheffield has treated 11,310 patients.Retrospective analysis of the prospectively maintained database, supplemented by disease-specificretrospective case-note review was carried out.Results: The steadily increasing annual treatment numbers provided immense opportunities toacquire large experience in the management of the common indications (over 5000 AVMs, over2500 vestibular schwannomas, over 1000 meningiomas etc). This resulted in dramatic changes in themanagement paradigms for vestibular schwannomas in the UK and there are encouraging signs thatthe same is happening for meningiomas. This large practice also offered deeper understanding of theresponse to radiosurgery of rare pathologies e.g. pineal tumours, trigeminal neuromas, phacomatosesand a large series of over 100 glomus jugulare tumours. The particular commissioning (reimbursement)arrangements in the United Kingdom have resulted in peculiarities of case-mix, particularly inwithholding treatment for many patients with metastases.Conclusions: Despite the unchanged principle of gamma knife structure, the developing technologyand particularly the evolving radiological support has offered an increasingly precise and tailoredtreatment. This paper will analyse the effects of these changes upon the treatment delivery andoutcome.12
16 th International Meeting of the Leksell Gamma Knife ® SocietyMarch 2012, Sydney, AustraliaBE-205Gamma knife radiosurgery inhibit progression of vestibularschwannoma with pre-treatment evidence of growth-aretrospective long term follow up studyTheresa Wangerid, Petter FöranderKarolinska University Hospital, Department of Neurosurgery, Stockholm, SwedenObjective: Gamma knife radiosurgery (GKRS) has for the last decades been an established alternativetreatment for patients with vestibular schwannoma (VS). Studies of patients treated with GKRS for VSshow tumor control (TC) rate in 90-97%. Epidemiological studies have shown that a large proportionof the VS are stationary when followed conservatively with repeated magnetic resonance images(MRI). The implication of these results could be that most VS are in no need for intervention. A majordrawback with many of the existing studies is short follow up times. This study will investigate thelong-term effect of GKRS on VS and evaluate the chance of growth inhibition after treatment of VSwith pre-treatment evidence of growth.Methods: We reviewed a cohort of 128 patients, 62 men and 66 women, with VS who had consecutivelybeen treated with GKRS at Karolinska University hospital between 1997-2003. Patients previouslytreated for VS, patients from abroad and patients with neurofibromatosis were excluded fromthe study. Mean age at time of treatment was 64 years (23-89). Patients were followed clinically fora median time of 96 months (11-165) and radiologically for 84 months (5-170). 5 patients were lostto follow up. 4 patients underwent GKRS for a second time. 6 patients had microneurosurgery due toprogressive tumor growth.Results: TC was achieved in 92% of patients after GKRS. Pre-treatment growth of VS was notcorrelated to rate of TC, strongly indicating that GKRS inhibit further growth of VS. 12 patientshad loss of TC, 10 were re-treated either with surgery (6 patients) or with GKRS (4 patients). Newtreatment with surgery or GKRS was performed in median in 49 months from the first treatment. Nocorrelation was noted between tumor size, age or gender of the patients and tumor control rate. 3%had trigeminal symptoms and 4% of the patients had facial nerve palsy after treatment.Conclusion: This study concludes excellent tumor control rate in patients with VS treated with GKRSin long time follow up. The tumor control results are not dependent on the pre-treatment growth, orvolume of the tumor.13
Page 2 and 3: 16 th International Meeting of the
Page 11: 16 th International Meeting of the
Page 63 and 64:
16 th International Meeting of the
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Author IndexAAhluwalia Manmeet 49,
Page 85:
RRadatz Matthias 12, 16Radatz Matth
show all

Plenary Oral Presentations - Macquarie University Hospital

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?