Gamma knife therapy for cavernous hemangiomas of the cavernous sinus: clinical outcome of 39 patients.

Keywords: cavernous hemangioma, gamma knife, cavernous sinus, radiosurgery, outcome

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     Cavernous hemangiomas can be managed in a number of ways.
     A retrospective study was carried out to evaluate the efficacy and safety of gamma knife (GK) for cavernous hemangiomas of the cavernous sinus (CHCS).
     From July 2004 to March 2010, forty-two patients with CHCS underwent gamma knife therapy at West China Hospital of Sichuan University. Among these patients, 38 patients underwent GK as the initial treatment; the other 4 cases had GK treatment after microsurgery. An average prescription dose was 13.3Gy (12-15Gy) at 47.9% (40-50%) isodose line. All patients were followed-up by periodical enhanced MRI scan and physical examination.
     The improvement of clinical symptoms and tumor control were analyzed.
     Thirty-nine patients accomplished follow-up with a mean duration of 38.4 months. Complete tumor remission (tumor size decreased more than 90%) was observed in 7 patients. Twenty-eight patients had significant tumor control (tumor size decreased more than 30%). No significant change in tumor size was reported in 4 patients. Clinical symptoms were reported including headache (33 cases), facial numbness (19 cases), facial pain (14 cases) and diplopia (6 cases). Significant improvement in headache, facial numbness, facial pain and diplopia was reported in 27, 11, 11 and 5 patients respectively. No newly developed cranial nerve damages were observed.
     This was a retrospective study.
     The preliminary result indicated that GK might be an effective and safe option for CHCS management.
     Long term follow-up and more cases are needed to investigate the advantage and disadvantage of this management.


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