Views: 1,479 | Downloads:
17
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Early Neurological Comp~ications After Stereotactic Radiosurgery I Radiotherapy
Dhanachai M 
,
Theerapancharoen V ,
Laothamatas J ,
Pongpech S ,
Kraiphibul P ,
Chanwitayanuchit T ,
Pochanugool L ,
Dangprasert S ,
Samvivad P ,
Sinpomchai V ,
Kuonsongtum V ,
Pirabul R ,
Yongvithisatid P
,
Theerapancharoen V ,
Laothamatas J ,
Pongpech S ,
Kraiphibul P ,
Chanwitayanuchit T ,
Pochanugool L ,
Dangprasert S ,
Samvivad P ,
Sinpomchai V ,
Kuonsongtum V ,
Pirabul R ,
Yongvithisatid P Objective
: To evaluate the neurological complications after stereotactic radiosurgery
(SRS) and stereotactic radiotherapy (SRT).
Material and Method
: The Ramathibodi Radiosurgery Unit started its service in August
1997, using the linear-accelerator based system. There were 144 patients treated from August 1997
to October 1999. Single fraction SRS was performed in 56 cases consisting of 46 arteriovenous
malformations (A VMs), 4 cranial nerve (CN) schwannomas, 3 pituitary adenomas, 2 meningiomas,
and I multiple hemangioblastomas. Eighty eight patients received multifractionated SRT, including
27 meningiomas, 17 pituitary adenomas, 13 benign and malignant gliomas, 8 brain metastasi(e)s, 5 CA
nasopharynx, 5 craniopharyngiomas, 5 CN schwannomas, 2 A VMs, 2 chordomas, and 4 others. After
treatment the patients were clinically evaluated every 1-6 months and MRI was scheduled at 6 or
12-month interval or when there were abnormal clinical signs/symptoms. The complications in-
cluded any new neurological complaints or findings during and after treatment.
Results
: Median follow-up time was 9.5 (0-20) months. Of 138 patients with available
follow-up data, there were 23 (13 SRS and 10 SRT) cases who experienced new neurological symp-
toms at 3 weeks -20 months (median
=
3 months) from the time treatment started. Symptoms in-
cluded headache, seizure, weakness, decreased vision, vertigo with/without ataxia, diplopia, dizzi-
ness, impaired memory, hemifacial spasm, decreased sensation and facial palsy. Three AVM patients
had intraventricular hemorrhage from the patent nidi. After symptomatic treatment there were 15
cases with complete recovery (including seizure control) and 6 with partial recovery. There were 2
deaths from ruptured A VM and progressive metastatic brain lesion. There were 79 patients who
had at least I follow-up MRI, and changes were detected in T2-weighted images in 19 cases at
3-18 months after treatment. Ten cases had symptoms corresponding to the image changes, the
other 9 patients were asymptomatic.
1730
M. DHANACHAI
et
: To evaluate the neurological complications after stereotactic radiosurgery
(SRS) and stereotactic radiotherapy (SRT).
Material and Method
: The Ramathibodi Radiosurgery Unit started its service in August
1997, using the linear-accelerator based system. There were 144 patients treated from August 1997
to October 1999. Single fraction SRS was performed in 56 cases consisting of 46 arteriovenous
malformations (A VMs), 4 cranial nerve (CN) schwannomas, 3 pituitary adenomas, 2 meningiomas,
and I multiple hemangioblastomas. Eighty eight patients received multifractionated SRT, including
27 meningiomas, 17 pituitary adenomas, 13 benign and malignant gliomas, 8 brain metastasi(e)s, 5 CA
nasopharynx, 5 craniopharyngiomas, 5 CN schwannomas, 2 A VMs, 2 chordomas, and 4 others. After
treatment the patients were clinically evaluated every 1-6 months and MRI was scheduled at 6 or
12-month interval or when there were abnormal clinical signs/symptoms. The complications in-
cluded any new neurological complaints or findings during and after treatment.
Results
: Median follow-up time was 9.5 (0-20) months. Of 138 patients with available
follow-up data, there were 23 (13 SRS and 10 SRT) cases who experienced new neurological symp-
toms at 3 weeks -20 months (median
=
3 months) from the time treatment started. Symptoms in-
cluded headache, seizure, weakness, decreased vision, vertigo with/without ataxia, diplopia, dizzi-
ness, impaired memory, hemifacial spasm, decreased sensation and facial palsy. Three AVM patients
had intraventricular hemorrhage from the patent nidi. After symptomatic treatment there were 15
cases with complete recovery (including seizure control) and 6 with partial recovery. There were 2
deaths from ruptured A VM and progressive metastatic brain lesion. There were 79 patients who
had at least I follow-up MRI, and changes were detected in T2-weighted images in 19 cases at
3-18 months after treatment. Ten cases had symptoms corresponding to the image changes, the
other 9 patients were asymptomatic.
1730
M. DHANACHAI
et
Download:
PDF