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Journal of Korean Neurosurgical Society 2006;40(4): 245-248.
Novalis Shaped Beam Radiation Treatment for Craniopharyngiomas.
Gi Taek Yee, Seong Rok Han, Sang Won Yoon, Chan Young Choi, Dong Joon Lee, Choong Jin Whang
Department of Neurosurgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea. gtyee@ilsanpaik.ac.kr
To evaluate the effectiveness of Novalis shaped beam radiation treatment as an adjuvant treatment in patients with craniopharyngiomas.
We reviewed 8 patients with craniopharyngiomas who had recurring tumors during follow-up or had residual lesions after primary surgery. Three of 8 patients were found to have recurrence after gross total excision of the tumor and 5 patents had residual lesions after subtotal resection. All patients were treated with fractionated stereotactic radiation treatment(FSRT) using Novalis system. The mean age of patients was 28 years (range 16~52). The median irradiation dose per fraction was 1.7Gy (range 1.7~2.0). The median fraction number was 23 (range 15~25), and the median total dose was 39.1Gy (range 25.5~42.5). Follow-up included MR imaging, and ophthalmologic and endocrine examinations.
The median follow-up period was 23 months (range 12~43). The local tumor control rate was 87.5%. One patient had a recurring tumor, in which cystic change developed 2 months after FSRT. Four patients showed a decrease in size of their tumor, while 3 patients remained stable. Seven out of 8 patients had hormonal dysfunction that remained unchanged after initial surgery. No further progression of visual impairment was observed.
FSRT using Novais system is effective and safe for the treatment of recurring or residual craniopharyngiomas without toxicity like optic neuropathy.
Key Words: Craniopharyngioma; Shaped beam radiation treatment; Optic neuropathy
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