Multisession stereotactic radiosurgery for large benign brain tumors of >3cm- early clinical outcomes
Azhar Rashid, Muhammad Ali Memon, Usman Ahmed, M. Phil, Muhammad Abid Saleem, Amer Iqtidar Bhatti, Naveed Ahmed and Abdul Sattar M. Hashim
Objective: To evaluate the clinical outcome of linear accelerator based multisession stereotactic radiosurgery (SRS) for large benign brain tumors of >3cm.
Methods: Between June 2009 and May 2011, 35 patients having large benign brain tumors of >3cm (≥15 cm3) were treated by multisession stereotactic radiosurgery. This retrospective study was carried out at Neurospinal & Medical Institute Karachi. There were 17 (48.6%) males and 18(51.4%) females. Median age was 36 years (range: 13-65 years). Median target volume was 49.4 cm3 (range: 15-184 cm3). The median marginal dose was 25 Gy (range: 20–27.5Gy) prescribed to a median 75% isodose line (range: 65-100%). Median number of 5 fractions were used ranging 3-5 fractions.
Results: All the patients tolerated treatment very well. 21 (58.3%) patients had remarkable clinical improvement of neurological symptoms, 14 (38.9%) patients had stable symptoms, and only one patient had transient worsening of symptoms. No permanent neurological damage or radiation injury was seen. Radiologically, 9 (25.7%) patients achieved reduction in size of the tumor, 26 (74.3%) patients were having stable disease, and overall control rate was found to be 100%. Median follow-up time from the end of SRS was 6.4 months (range: 1-22.5months).
Conclusion: Linear accelerator based multisession stereotactic radiosurgery for large benign brain tumors of >3cm is effective and well tolerated.
Keywords: Stereotactic radiosurgery (SRS), multi session SRS, brain tumors, linear accelerator, benign brain tumors, radiation injury.