4.6 Article

Stereotactic radiosurgery for orbital cavernous hemangiomas

Journal

JOURNAL OF NEUROSURGERY
Volume 138, Issue 6, Pages 1622-1629

Publisher

AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2022.8.JNS221222

Keywords

Gamma Knife; hemangioma; orbital; progression-free survival; stereotactic radiosurgery

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The objective of this study was to evaluate the safety and efficacy of single-session Gamma Knife radiosurgery (GKRS) for orbital cavernous hemangiomas (OCHs). The results of this study demonstrate that GKRS is a safe and effective treatment for OCHs, with significant improvements in visual acuity and visual field deficits, as well as tumor regression, observed over long-term follow-up. No adverse radiation effects were observed.
OBJECTIVE The goal of this study was to assess the safety and efficacy of single-session Gamma Knife radiosurgery (GKRS) for orbital cavernous hemangiomas (OCHs).METHODS Patients who presented with an OCH between September 1999 and May 2022 and were treated with single -session GKRS were included in this single-center cohort study.RESULTS There were 23 patients (7 males and 16 females) in this study. The median margin dose was 12 Gy (range 11-13 Gy). The median clinical and radiological follow-ups were 45 months (range 5-190 months) and 45 months (range 6-190 months), respectively. Nine (69.2%) of 13 patients with visual acuity impairment had improvement in best corrected visual acuity. Of the 8 patients with visual field defects, 5 patients (62.5%) had complete resolution. Tumor regression was observed in 22 patients (95.7%). The mean relative reduction in tumor volume was 82.6% & PLUSMN; 23.7%. The relative reductions in tumor volume were 33%, 49%, 72%, 84%, and 89% at 6, 12, 24, 36, and 48 months, respectively. Adverse effects of radiation were not observed.CONCLUSIONS GKRS appears to be safe and efficacious for treating OCHs over long-term follow-up. The treatment is associated with a high rate of regression in OCHs and remarkable improvement in both visual acuity and visual field deficits.

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