Gamma Knife Surgery In The Management Of Orbital Tumors

Desheng Xu1, Dong Liu2, Hong Zhang1, Zhiyuan Zhang1, Yipei Zhang1, Yanhe Li1, Xiaomin Liu, MD, PhD3, Qiang Jia1, Ligao Zheng1, Guoxiang Song1

12nd Hospital of TJMU, Tianjin, China 2Tianjin, China 3Department of Neurosurgery and Gamma Knife Center, 2ND Hospital of Tianjin Medical University

Keywords: orbit, gamma knife, vision, tumor, outcome

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     The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with orbital tumors.
     This is a retrospective clinical evaluation of 260 patients with orbital tumors treated with GKS from Sep 1995 through Dec 2007.The series included 112 male and 148 female patients with a mean age of 37.1±17.6 years (range 1.7–85 years). The diagnoses were based on pathological analyses in 123 patients, confirmed by characteristic clinical and radiographic findings in 98 patients, and uncertain in the remaining 39.There were 61 meningioma , 43 cavernous hemangioma, 31 epithelial tumors of the lacrimal gland, 25 venous angioma, 16 schwannoma, 14 malignant choroidal melanoma, 7 optic nerve gliomas , 7 metastasis, 6 pseudotumor of the orbit, 4 capillary hemangioma,3 retinoblastoma, 3 fibromatosis, 1 lipoma . 
     The tumor margin dose ranged from 8 to 40Gy. The median target volume was 6.2cm3 (range 0.2–35.6 cm3).
     At a median follow-up period of 35.7±16.2 months (range, 12 to 114 months), tumor shrinkage was observed in 171 patients (65.77%), and the tumor size was stable in 74 (28.46%). Persistent neuroimaging demonstrated evidence of progression in only 15 patients (5.77%): 9 underwent repeated GKS and 6 referred for surgical treatment. Visual acuity was preserved in 191 patients. 106 patients experienced some degree of visual sight improvement. Deterioration of visual acuity was found in 21 of 212 patients who had useful visual sight before treatment. 27 patients (10.38%) experienced
     This is a retrospective study.
     Gamma knife radiosurgery provides an effective management strategy in patients with orbital tumors.
     It achieves excellent neurological function preservation and few treatment-related complications.


Project Roles:

D. Xu (), D. Liu (), H. Zhang (), Z. Zhang (), Y. Zhang (), Y. Li (), X. Liu (), Q. Jia (), L. Zheng (), G. Song ()