Gamma Knife Radiosurgery For Sellar Region Tumors Touching/compressing The Optic Apparatus

Yamamoto Masaaki1, Takuya Kawabe2, Yasushi Nagatomo1, Bierta E Barfod1, Yoichi Urakawa1

1Katsuta Hospital Mito GammaHouse, Ibaraki, Japan, 2Hitachi-Naka, Japan

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     Debate continues as to whether stereotactic radiotherapy or stereotactic radiotherapy (SRT) should be chosen for patients with sellar region tumors touching or even compressing the optic apparatus (OA).
     Our purpose was to study visual outcomes.
     We studied our consecutive series of 82 patients (51 females, 31 males, mean age; 52 range; 14-85 years) who underwent gamma knife radiosurgery (GKRS) for the aforementioned condition before 2003. The diagnosis was meningioma (MEN) in 34 patients, pituitary adenoma (PT) in 27, craniopharyngioma (CP) in 19 and other in two. The median tumor volume was 5.2 cc (range; 0.3-66.3 cc). Median doses at the tumor periphery and OA were 12.0 Gy and 10.8 Gy (ranges; 1.2-18.0 Gy and 2.5-18.6 Gy), respectively.
     Post-GKRS follow-up ranged from 11 to 150 (median; 72) months, excluding 10 deceased patients. Among all 82 patients, further procedures (FP, surgery or SRS) were required in six (7.3%) because of further tumor growth. Using the Kaplan-Meier method, the FP-free rates at the 10th post-SRS year were calculated to be 89% overall, 100% for the MEN, 92% for the PT and 73% for the CP groups. GKRS-induced optic neuropathy occurred in one patient (1.2%).
     This study was retrospective.
     In patients with sellar region tumors touching or even compressing the OA, GKRS achieves good long-term results. .
     The opinion that only SRT should be chosen is not warranted


Project Roles:

Y. Masaaki (), T. Kawabe (), Y. Nagatomo (), B. Barfod (), Y. Urakawa ()