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Evaluation of tumour response after gamma knife radiosurgery for residual vestibular schwannomas based on MRI morphological features

Cited 37 time in Web of Science Cited 33 time in Scopus
Authors
Yang, S-Y; Kim, D G; Chung, H-T; Park, S-H; Paek, S H; Jung, H-W
Issue Date
2007-08-04
Publisher
BMJ Publishing Group
Citation
J Neurol Neurosurg Psychiatry 2008;79:431-6
Keywords
Actuarial AnalysisBrain/pathologyFollow-Up StudiesHalf-LifeHumans*Magnetic Resonance ImagingMicrosurgeryNecrosisNeoplasm, Residual/diagnosis/pathology/*surgeryNeuroma, Acoustic/diagnosis/pathology/*surgery*RadiosurgeryReoperationTumor Burden
Abstract
OBJECTIVE: To evaluate tumour response after gamma knife (GK) radiosurgery for residual vestibular schwannoma (VS) based on MRI morphological features. METHODS: Sixty-one patients with histopathologically confirmed VS underwent GK radiosurgery with marginal tumour doses of 9.0-14.0 Gy (mean, 12.5). Mean tumour volume at GK radiosurgery was 3.65 ml (range, 0.52-15.50). GK radiosurgery was performed 0.3-95.7 months (median, 5.8) after microsurgery. Tumour volumes and half-reduction time were calculated using serial MRI. The morphological features of VS were documented by pre-microsurgical MRI. Histopathological investigation included Antoni-type dominance, the proliferation marker Ki-67 and tumour vascularity. RESULTS: Median duration of radiological follow-up was 53.7 months (range, 24.1-102.2) and the 8-year actuarial tumour control rate was 93.5%. No factor was associated with tumour control, although a cystic VS had borderline significance (p = 0.089). Mean tumour half-reduction time was 8.70 years (range, 0.57-79.89) and tumour half-reduction time in cystic VS proved to be significantly shorter than those in solid VS (p = 0.006). Thrombotic vessels (p = 0.015) and abnormal vessel proliferation (p = 0.003) were significantly more prominent in cystic VS than those in solid VS. CONCLUSIONS: GK radiosurgery appeared to be an effective treatment modality for residual tumour control after microsurgery. Owing to having relatively abundant tumour vascularity, residual solid portions of cystic VS resulted in efficient shrinkage after GK radiosurgery. Therefore, GK radiosurgery was found to be a rewarding therapeutic approach to the residual solid portions of cystic VS.
ISSN
1468-330X (Electronic)
Language
English
URI
http://hdl.handle.net/10371/62004
DOI
https://doi.org/10.1136/jnnp.2007.119602
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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