Stereotactic Radiosurgery in Brain Cavernomas: Single-Center Experience

INTRODUCTION: In this study, we aimed to present our treatment results of patients with intracranial Cavernoma who treated with Stereotactic Radiosurgery (SRS) by using CyberKnife
METHODS: Between April 2010 and December 2017, the data of 19 patients treated with SRS in our clinic with the diagnosis of Cavernoma were evaluated retrospectively.
RESULTS: The median follow-up time was 82 (range; 9-100 months) months. SRS was performed in median one fraction (range, 1-3) and according to the size of the lesion the prescription dose was ranged from 12 to 21 Gy (median, 15 Gy). During the post-SRS follow-up period, 6 of the 10 patients with headache had a complete response, 3 patients had a partial response and 1 patient had no response. 3 of the 4 patients with seizure had a partial response and 1 patient had a stable response in seizure frequency. 1 of the 2 patients with vision problem had a complete response and 1 had no change. 1 of the 3 patients with hemi paresthesia had a complete response and 2 had no change. Radiological evaluations in post-SRS follow-up revealed complete response in 4 patients, partial response in 3 patients, stable disease in 9 patients, and progression in 3 patients. Rebleeding was detected in 1 (5.3%) of 3 progressive patients at 17th months and radiation-induced radionecrosis was detected in other 2 patients at 9th and 11th months. There were no procedure-related complications resulting in mortality.
DISCUSSION AND CONCLUSION: In cavernoma patients with high risk for surgical intervention and/or especially in patients with high risk for bleeding, SRS is an effective and alternative treatment to surgery.

Beyin Kavernomlarında Stereotaktik Radyocerrahi: Tek Merkez Deneyimi

GİRİŞ ve AMAÇ: In this study, we aimed to present our treatment results involving patients with intracranial cavernomas who were treated with stereotactic radiosurgery (SRS) by using a CyberKnife®.

YÖNTEM ve GEREÇLER: Between April 2010 and December 2017, data from 19 patients treated with SRS in our clinic with the diagnosis of cavernomas were retrospectively evaluated.

BULGULAR: The median follow-up time was 82 months (range: 9–100 months). SRS was performed in the median 1 fraction (range: 1–3); according to the lesion size, the prescription dose ranged from 12 to 21 Gy (median: 15 Gy). During the post-SRS follow-up period, 6 out of the 10 patients with a headache had a complete response, 3 patients had a partial response, and 1 patient had no response. Further, 3 out of the 4 patients with a seizure had a partial response and 1 patient had a stable response in seizure frequency. Furthermore, 1 out of the 2 patients with a vision problem had a complete response and 1 had no change. Also, 1 out of the 3 patients with hemiparesthesia had a complete response and 2 had no change. Radiological evaluations in the post-SRS follow-up period revealed a complete response in 4 patients, partial response in 3 patients, stable disease in 9 patients, and progression in 3 patients. Rebleeding was detected in 1 (5.3%) out of 3 progressive patients at the 17th month, and radiation-induced radionecrosis was detected in the other 2 patients at the 9th and 11th months. There were no procedure-related complications resulting in mortality.
TARTIŞMA ve SONUÇ: In cavernoma patients with a high risk for surgical intervention and/or patients with high risk for bleeding, SRS is an effective and alternative treatment to surgery.