ABSTRACT
Objective To evaluate the effect of MRS-assisted stereotactic radiosurgery (SRS) for small recurrent high grade glioma (HGG).Methods A total of 54 patients with recurrent HGG were selected,the tumor diameter was less than 3 cm,the patients were divided into the conventional MRI group of 26 cases,and MRI+MRS group of 28 cases.The target region of the conventional MRI group was defined as the enhanced and short T1,long T2 area;MRI+MRS group was defined as the region of Cho/NAAindex (CNI) ≥1.6 in the surrounding short T1,long T2 and enhanced area.All the patients were followed up at least 12 months,analysed their therapeutic effect.Results Compared with the conventional MRI group,MRS+MRI group margin dose increased (19.46 Gy vs.13.58 Gy),the average diameter of target were smaller (2.6 cm vs.3.0 cm),progression-free survival was longer (6.8 months vs.5.6 months),the 1-year survival rate was higher (78.6％ vs.50.0％),and the occurrence rate of brain edema was lower (5 vs.17),the difference was statistically significant (P＜0.05).Conclusion MRI+-MRS assisted SRS helps to accurately identify the scope of HGG,its short term effect was superior.
ABSTRACT
Objective To investigate the treatment effect of gamma knife radiosurgery for hypothalamic hamartomas. Methods Gamma knife radiosurgery was performed in 9 patients with gelastic seizures. Collimator helmets (4 and 8 mm) were used and a radiosurgery plan was designed to cover 90% of the hamartoma at the 40%~55% isodose curve with the center dose of 28~40 Gy and the margin dose of 12~18 Gy. The clinical outcome was evaluated with the Tan’s scale. Results No complications due to gamma knife radiosurgery occurred. A follow-up from 24 to 54 months showed effectiveness in 7 patients, disappearance of seizure in 1 patient, rare occurrence in 3 patients, significantly reduced occurrence in 2 patients, improvement in seizure control in 1 patient, but ineffectiveness in 2 patients. Conclusion As an approach to the treatment of hypothalamic hamartomas, gamma knife is a safe and cost-effective therapy with rare side effects for hypothalamic harmatomas.