Gamma Knife robotic microradiosurgery of pituitary adenomas invading the cavernous sinus: treatment concept and results in 89 cases.


Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan, GKRmoto@aol.com.

Abstract

The objective of the present retrospective study was evaluation of results of "robotic microradiosurgery" of pituitary adenomas invading the cavernous sinus. Eighty-nine patients with such tumors underwent management using Leksell Gamma Knife model C with automatic positioning system. There were 77 residual and 12 recurrent neoplasms. The applied radiosurgical treatment plan was based on the use of multiple isocenters, mainly of smaller size, which were positioned compactly within the border of the lesion with resultant improved dose homogeneity, increased average dose within the target, and sharp dose fall outside the treated volume. The marginal dose varied from 12 to 25 Gy (mean, 18.2 Gy) in non-functional pituitary adenomas (43 cases), and from 12 to 35 Gy (mean, 25.2 Gy) in hormone-secreting ones (46 cases).

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