Plenary Oral Presentations - Macquarie University Hospital

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16 th International Meeting of the Leksell Gamma Knife ® SocietyMarch 2012, Sydney, AustraliaBE-306Preliminary Results after Multisession Gamma KnifeRadiosurgery for Perioptic Meningiomas.1Alberto Franzin, 1 Piero Picozzi, 1 Marzia Medone, 2 Antonella Del Vecchio, 3 Angelo Bolognesi,4Stefania Bianchi-Marzoli, 1 Camillo Ferrari da Passano, 1 Pietro Mortini1Dept. of Neurosurgery and Radiosurgery IRCCS S. Raffaele, UniversitÃ Vita-Salut2Dept. of Medical Physics, IRCCS San Raffaele, UniversitÃ Vita-Salute, Milano, I3Dept. of Radiation Oncology, IRCCS S. Raffaele, Milano, Italy4Dep. Of Ophthalmology, IRCCS San Raffaele, UniversitÃ Vita-Salute Milano, ItalyObjective: To evaluate the effectiveness and safety of a Gamma Knife treatment in three consecutivedays (multisession) in patients with parasellar meningioma in close contact to the optic nerve andchiasm.Methods: Between January 2006 and September 2010 49 patients (41 females, 8 males, mean age 57years) underwent multisession gamma knife treatment at San Raffaele <strong>Hospital</strong> for a meningioma inclose contact to the optic nerve and chiasm. Five patients have been treated for optic nerve meningioma,44 for a parasellar meningioma. Preoperative decreased visual acuity or visual fields defect wasfound in 28 patients. Gamma Knife radiosurgery was delivered in three sessions with a mean prescriptionisodose of 6.8 Gy per session (range 6.5-7 Gy) and a mean total prescription isodose of 20.7Gy (range 19.5-21 Gy). Mean tumor volume was 8.8 ml (median 7.6, range 0.33-34.2). Maximumdose to the optic apparatus was always below 7 Gy for each session (mean 5 Gy).Results: Median follow-up was 29.5 months (range 6-57). Overall tumor control rate was 100%.Tumor volumetric reduction was observed in 33 patients (67%), whereas in 16 patients (33%) novolumetric change was recorded. No patient experienced worsening of visual function, in 5 patients(10%) visual acuity improved after treatment; visual field improvement occurred in 4 patients (8%).Cranial nerve function improvement was recorded in 2 patients (4%); one patient experienced VIcranial nerve paresis (2%).Conclusion: This preliminary experience suggests that multisession radiosurgery with Gamma Knifecan be a safe and effective treatment for tumors immediately adjacent to segments of the opticapparatus.18
16 th International Meeting of the Leksell Gamma Knife ® SocietyMarch 2012, Sydney, AustraliaBE-308Gamma Knife Radiosurgery for GrowthHormone-Secreting Pituitary Adenoma1Alberto Franzin, 1 Marco Losa, 1 Piero Picozzi, 1 Giorgio Spatola, 2 Angelo Bolognesi, 1 Micol Valle,1Lorenzo Gioia, 1 Pietro Mortini1Dept. of Neurosurgery and Radiosurgery, IRCCS S. Raffaele, UniversitÃ Vita-Salu2Dept. of Radiation Oncology, IRCCS S. Raffaele, Milano, ItalyObjective: Single-session radiosurgery with Gamma Knife (GK) may be a potential adjuvant treatmentin acromegaly. We analyzed the safety and efficacy of GK in patients who had previously receivedmaximal surgical debulking at our hospital.Methods: The study was a retrospective analysis of hormonal, radiological, and ophthalmologic datacollected in a predefined protocol from 1994 to 2009. The mean age at treatment was 42,3 years(range 22-67 yrs).One hundred and three acromegalic patients, 62 women and 41 men, participatedin the study. The median follow-up was 71 months (interquartile range 43–107 months). All patientswere treated with GK for residual or recurrent GH-secreting adenoma.Results: Sixty-three patients (61.2%) reached the main outcome of the study. The rate of remissionwas 58.3% at 5 years (95% CI 47.6– 69.0%). Other 15 patients (14.6%) were in remission after GKwhile on treatment with somatostatin analogues. No serious side effects occurred after GK. Eight of102 patients (7.8%) experienced a new deficit of pituitary function. New cases of hypogonadism,hypothyroidism, and hypoadrenalism occurred in 4 of 77 patients (5.2%), 3 of 95 patients (3.2%),and 6 of 100 patients at risk (6.0%), respectively.Conclusions: In a highly selected group of acromegalic patients, GK treatment had good efficacy andsafety. This may lead to reconsider the role of GK in the therapeutic algorithm of acromegaly.19
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Author IndexAAhluwalia Manmeet 49,
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RRadatz Matthias 12, 16Radatz Matth
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Plenary Oral Presentations - Macquarie University Hospital

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