Safety And Efficacy Of Gamma Knife Radiosurgery For Glomus Jugulare Tumors. A Preliminary Report Of 8 Cases From Pakistan.Abid Muhammed Saleem1, AZHAR RASHID2, MA Sattar1, Mohammed Ali Memon1, Naveed Ahmed11Pakistan Gamma Knife and Stereotactic Radiosurgery Center, Neurospinal and Medical Institute, Karachi, Pakistan 2Pakistan Gamma KNife & Stereotactic Radiosurgery Center, Neurospinal & Medical Institute Keywords: glomus tumor, gamma knife, outcome, radiosurgery, skull base
Glomus jugulare tumors are rare, benign but locally destructive lesions located in one of the most poorly accessible regions of skull base. Excision is fraught with the risk of injury to the surrounding neurovascular structures and excessive bleeding even with pre-operative embolization. Conventional fractionated external beam radiotherapy was used to treat residual tumors with varying degrees of success.
The aim of the present study was to ascertain the safety and efficacy of Gamma Knife Radiosurgery as primary or adjunct form of therapy.
A review of eight patients was done who underwent GKS for glomus jugulare tumors since the installation of Ist Gamma Knife 4c in Pakistan on May 2008 to Oct.2009.There was 5 females and 3 male patients. The average age was 40 years.(range 24 – 65 yrs).
Seven patients received GKS as primary treatment. Mean tumor size was 15 cm ( range 466.7mm to 23.1 cm.)Mean Tumor margin dose was 13.7 Gy (range 12-14Gy) at the mean isodose line of 48% (range 43-50%).The mean coverage achieved was 94.5% (range 82 – 99%).The median interval for follow up was 10 months (range2 – 18 months).
Two patients showed decrease in size and the volume remained unchanged in remaining six. All patients improved clinically. There were no new neurological deficits or acute complications. None of the tumors increased in volume during the observation period.
This is a retrospective study.
GKS for GJT appears to be safe and effective in this short term study. GKS provides superior biologically effective tumor dose with better dose sparing of adjacent brain stem and cranial nerves.
Although the initial results are encouraging, a long term follow up is needed because of the slow growth rate of the tumor. Project Roles:
A. Saleem (), A. RASHID (), M. Sattar (), M. Memon (), N. Ahmed ()