Gamma Knife radiosurgery for cerebral cavernous malformation

Cheng Chia Lee, Wei Hsin Wang, Huai Che Yang, Chung Jung Lin, Hsiu Mei Wu, Yen Yu Lin, Yong Sin Hu, Ching Jen Chen, Yu Wei Chen, Chien Chen Chou, Yo Tsen Liu, Wen Yuh Chung, Cheng Ying Shiau, Wan Yuo Guo, David Hung-Chi Pan, Sanford P.C. Hsu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

This is a retrospective study examining the efficacy and safety of Gamma Knife radiosurgery (GKS) in treating patients with cerebral cavernous malformations (CCMs). Between 1993 and 2018, 261 patients with 331 symptomatic CCMs were treated by GKS. The median age was 39.9 years and females were predominant (54%). The median volume of CCMs was 3.1 mL. The median margin dose was 11.9 Gy treat to a median isodose level of 59%. Median clinical and imaging follow-up times were 69 and 61 months, respectively. After the initial hemorrhage that led to CCM diagnosis, 136 hemorrhages occurred in the period prior to GKS (annual incidence = 23.6%). After GKS, 15 symptomatic hemorrhages occurred within the first 2 years of follow-up (annual incidence = 3.22%), and 37 symptomatic hemorrhages occurred after the first 2 years of follow-up (annual incidence = 3.16%). Symptomatic radiation-induced complication was encountered in 8 patients (3.1%). Mortality related to GKS occurred in 1 patient (0.4%). In conclusion, GKS decreased the risk of hemorrhage in CCM patients presenting with symptomatic hemorrhage. GKS is a viable alternative treatment option for patients with surgically-inaccessible CCMs or significant medical comorbidities.

Original languageEnglish
Article number19743
JournalScientific reports
Volume9
Issue number1
DOIs
StatePublished - 1 Dec 2019

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