Research Article
Volume 12 Issue 7 - 2020
Gamma Knife Surgery Safety and Efficacy in the Management of Residual Critically Located Deep-Seated Partially Cystic Pilocytic Astrocytomas
Raef Farouk Ahmed Hafez*
Professor, Department of Neurosurgery and Gamma Knife Center, International Medical Center (IMC), Cairo, Egypt
*Corresponding Author: Raef Farouk Ahmed Hafez, Professor, Department of Neurosurgery and Gamma Knife Center, International Medical Center (IMC), Cairo, Egypt.
Received: March 25, 2020; Published: June 03, 2020




Abstract

Objective: Complete surgical extirpation of pilocytic astrocytoma is usually curative, however when these tumors are critically deeply-seated gross total resection is usually not feasible and ill-advised because of the high morbidities. The objective of this study is to evaluate the outcomes of Gamma Knife Surgery in the management of critical deep-seated postoperative residual partially cystic pilocytic astrocytoma < 3 cm in maximum diameter targeting the solid mural nodule.

Patients and Methods: This study included 9 consecutive patients treated at the International Medical Center-Gamma knife center- Cairo Egypt, from 2003 till the end of 2017. The mean follow-up period was 60 months. The mean treated solid mural nodule volume is 2 cc, the mean peripheral prescription dose is 11.7Gy and the mean maximum dose is 29.4Gy.

Results: At the last follow-up, 7 patients (78%) have tumor growth control. Two patients were reported having progression of treated whole tumor. In this study the overall survival rate with mean follow up period of 60 months is 88.9%. The overall actuarial tumor progression-free survival (free from progression) at 1, 3, 5 and 8 years was 78%, 72.7%, 71% and 60% respectively.

Conclusion: This study demonstrates favorable outcome of GKS in the management of residual critically deep-seated partially cystic PAs < 3 cm in maximum diameters when targeting the solid mural nodule allowing coverage of the nidus with the maximum GKS radiation dose that resulting in significant tumor control and cyst reduction.

Keywords: Astrocytoma; Gamma Knife Surgery; Pilocytic Astrocytoma; Stereotactic Radiosurgery

References

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Citation: Raef Farouk Ahmed Hafez. “Gamma Knife Surgery Safety and Efficacy in the Management of Residual Critically Located Deep-Seated Partially Cystic Pilocytic Astrocytomas”. EC Neurology 12.7 (2020): 29-37.

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