Phase II Study to Assess the Efficacy of Hypofractionated Stereotactic Radiotherapy in Patients With Large Cavernous Sinus Hemangiomas

Wang, Xin; Liu, Xiaoxia; Mei, Guanghai; Dai, Jiazhong; Pan, Li; Wang, Enmin

doi:10.1016/j.ijrobp.2011.12.051

Cited by 23 publications

(20 citation statements)

References 19 publications

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“…However, our study as well as reports from inside and outside China all pointed out [15,22,23,24,25,26,27,28] that MRI shows CSHs with a low intensity or isointensity on T1-weighted images and with a high signal intensity on T2-weighted images. CSHs were intensely enhanced by gadolinium-DTPA at a dose of 0.15 mmol/kg.…”

Section: Introductionsupporting

confidence: 45%

Magnetic Resonance Standard for Cavernous Sinus Hemangiomas: Proposal for a Diagnostic Test

Chen²,

Zhu³

et al. 2014

Eur Neurol

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Background: By definition, a cavernous sinus is a vascular plexus. A hemangioma is a vascular tumor which is rich in vascular plexus and caused by vascular deformity or tumor-like proliferation. Radiosurgery can effectively control the growth of smaller cavernous sinus hemangiomas (CSHs). This paper aimed to quantify the MRI characteristics of CSHs which provided a basis for further treatment. Methods: A retrospective analysis was conducted of the MRI characteristics of 133 cavernous sinus lesion patients between January 2006 and December 2009, and none of them was diagnosed without histology. Two groups were set apart according to the pathological results: a CSH group (24 patients) and a non-CSH group (109 patients). The latter was further divided into 3 categories: a meningioma group (33 patients), a neurilemmoma group (37 patients) and a miscellaneous group (39 patients). A single-factor χ² analysis was performed to analyze the data on the 12 MRI characteristics. Results: T2-weighted ultrahigh signal, signal uniformity, dumbbell-like appearance and infiltration of the sellar region were considered statistically significant for the differentiation of CSHs from non-CSHs. If these 4 items served as the diagnostic criteria, the sensitivity, specificity and accuracy was 87.5, 96.3 and 94.7%, respectively. Conclusion: Smaller CSHs can be treated by radiosurgery directly, without performance of a pathological biopsy.

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Section: Introductionsupporting

confidence: 45%

Magnetic Resonance Standard for Cavernous Sinus Hemangiomas: Proposal for a Diagnostic Test

Chen²,

Zhu³

et al. 2014

Eur Neurol

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“…However, complete resection of these tumors is a great challenge because of excessive intraoperative hemorrhage and the potential of injury to cranial nerves due to the complicated neurovascular structures of the cavernous sinus [17,20,22,[25][26][27]37], despite recent advances in microsurgical techniques [4,23,29,37]. In most previous studies the total resection rate was only 30 %-64 % [4,23,29,33], and the incidence of postoperative complications was as high as 71 % [4]. Because of the high risk of microsurgery, many noninvasive techniques have been tried for these patients [7,11].…”

Section: Discussionmentioning

confidence: 99%

“…Usually, hypofractionated stereotactic radiotherapy is recommend in our hospital for large-volume CaSHs. In 2011, Wang et al reported the preliminary results of a prospective phase II trial of hypofractionated stereotactic radiotherapy for patients with large-sized (>20 cm 3 ) CaSHs [33]. The trial showed that hypofractionated stereotactic radiotherapy of 21 Gy delivered in three fractions is effective in reducing the tumor volume without causing any new deficits and can be considered as a treatment modality for large CaSHs.…”

Section: Discussionmentioning

confidence: 99%

A new classification and clinical results of Gamma Knife radiosurgery for cavernous sinus hemangiomas: a report of 53 cases

Tang

Wang

et al. 2015

Acta Neurochir

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Our study showed that GKS is a useful and safe therapeutic method for CaSHs as both a primary and adjuvant treatment. The new classification of CaSHs may help predict their clinical course during tumor development and treatment response after GKS. Further studies with long-term follow-up and larger numbers of cases are necessary to optimize the treatment conditions and verify the benefit of this treatment.

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“…Although many cases of large tumors in this study exhibited tumor shrinkage (Grades I-III) without inducing obvious neurological impairments, hypofractionated SRS may still be an option for these cases to increase the dose of radiation without increasing the toxicity. 21 The rate of short-term and perpetual complications of GKS for CSHs is relatively low. Only 1 of 59 patients had additional trigeminal nerve disturbance in the systematic review by Wang et al 22 None of our patients developed new GKS-related neurological impairments, except for the 1 case of temporary headache, which may have been related to fixation of the head-stabilization frame.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of Gamma Knife surgery for cavernous sinus hemangiomas

Ren¹,

Zhang²,

Wang³

2012

JNS

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Object The purpose of this study was to gain an understanding of the efficacy and safety of Gamma Knife surgery (GKS) for the treatment of cavernous sinus hemangiomas (CSHs). The authors report on 16 patients who underwent GKS as a primary or adjuvant treatment for CSH. Methods Sixteen patients harboring CSHs (14 women and 2 men ranging in age from 21 to 65 years [mean 41.3 years]) underwent GKS at West China Hospital. In 4 patients the diagnosis was based on histological findings; in the other 12 patients it was based on findings on MR images. After patients were given a local anesthetic agent, the treatments were performed using a Leksell Gamma Knife model C. Gadolinium-enhanced MR images of T1-weighted, T2-weighted, and FLAIR sequences were obtained to determine the pretreatment location of the lesion. A mean peripheral dose of 13.3 Gy (range 11–14 Gy) was directed to the 40%–50% isodose line. Results The mean follow-up time in this study was 21.5 months (range 12–36 months). In 11 of 12 patients with symptoms, clinical improvement was reported at an average of 3.3 months (range 1–8 months) after GKS. Significant or partial tumor shrinkage was observed in 14 patients (87.5%) at the last follow-up. No new neurological impairments were reported after GKS. Conclusions Magnetic resonance imaging may play an important role in the preoperative diagnosis of CSHs. Gamma Knife surgery may be a safe and effective primary or adjuvant treatment option for CSHs; however, long-term follow-up with more cases is needed to verify the benefits of this treatment.

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Phase II Study to Assess the Efficacy of Hypofractionated Stereotactic Radiotherapy in Patients With Large Cavernous Sinus Hemangiomas

Cited by 23 publications

References 19 publications

Magnetic Resonance Standard for Cavernous Sinus Hemangiomas: Proposal for a Diagnostic Test

Magnetic Resonance Standard for Cavernous Sinus Hemangiomas: Proposal for a Diagnostic Test

A new classification and clinical results of Gamma Knife radiosurgery for cavernous sinus hemangiomas: a report of 53 cases

Clinical results of Gamma Knife surgery for cavernous sinus hemangiomas

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