Safety and Efficacy of Primary Hypofractionated Gamma Knife Radiosurgery for Giant Hypothalamic Hamartoma

Tripathi, Manjul; Maskara, Prasant; Sankhyan, Naveen; Sahu, Jitendra Kumar; Kumar, Rakesh; Kumar, Narendra; Ahuja, Chirag; Kaur, Parwinder; Kaur, Rupinder; Batish, Aman; Mohindra, Sandeep

doi:10.1007/s12098-020-03637-w

Indian J Pediatr

2021

DOI: 10.1007/s12098-020-03637-w

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Safety and Efficacy of Primary Hypofractionated Gamma Knife Radiosurgery for Giant Hypothalamic Hamartoma

Manjul Tripathi

Prasant Maskara

Naveen Sankhyan

et al.

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Cited by 7 publications

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“…As enumerated by Tripathi et al [4] various treatment options are available, the most known ones include open surgery, endoscopic ultrasound-guided disconnection, stereotactic radiosurgery, stereotactic radiofrequency thermocoagulation, and laser interstitial thermocoagulation therapy (LITT).…”

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confidence: 99%

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Gamma Knife for Giant Hypothalamic Hamartomas—Not the Only Effective Tool in the Kit

2021

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confidence: 99%

“…Tripathi et al [4] have explored the utility of primary hypofractionated gamma knife for giant hypothalamic hamartomas in 3 cases. Of these, one had class I and two had class III outcome at a follow-up between 24-30 mo.…”

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confidence: 99%

Gamma Knife for Giant Hypothalamic Hamartomas—Not the Only Effective Tool in the Kit

2021

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Seizure outcomes and safety profiles of surgical options for epilepsy associated to hypothalamic hamartomas. A systematic review and meta-analysis

Rizzi,

Nichelatti,

Ferri

et al. 2023

Epilepsy Research

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Gamma Knife Radiosurgery for Hypothalamic Hamartoma: A Multi-Institutional Retrospective Study on Safety, Efficacy, and Complication Profile

Tripathi,

Sheehan,

Niranjan

et al. 2024

Neurosurgery

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BACKGROUND AND OBJECTIVES: Gamma knife radiosurgery (GKRS) is a safe and effective treatment option for hypothalamic hamartomas (HH), but there is no consensus opinion on its timing, dosage, and follow-up. The aim of this study was to define the safety, efficacy, outcome, and complication profile of GKRS in this patient population. METHODS: This retrospective multicentric study involved 39 patients with the mean age of 16 ± 14.84 years. Early seizures resulted in an earlier age of diagnosis in 97% of patients. At baseline, no endocrine abnormalities were seen in 75% of patients while 18.9% showed precocious puberty (PP). The median target volume was 0.55 cc (0.1-10.00 cc), and a median margin dose of 16 Gy (8.1-20.0 Gy) was delivered in a single session. All patients were evaluated for clinical, endocrinological, and radiological outcomes. RESULTS: The median follow-up was 5 (0.1-15) years. The median target volume of the cohort was 0.55 (0.35-1.77) cc. The largest HH was of 10 cc. 24/39 (61.5%) were small HH (Regis I-III). At presentation, 94.8% patients suffered from seizures (87.18% with gelastic seizures). 7/39 patients (17.9%) were presented with both PP and epilepsy. Only one (2.6%) patient presented with PP alone. 29 patients had more than 3-year follow-up. All received ≥16 Gy targeting complete HH. 28% of patients showed regression in HH volume. Patients with Regis grade I-III and longer follow-up (>75 months) showed gradual improvement in seizures. 16/29 patients (55.2%) achieved good seizure control (Engel I/II) while 13 (44.8%) were in Engel III/IV status. Nine patients needed adjuvant treatment because of poor seizure control. Eight patients suffered from transient increase in seizures. One patient developed poikilothermia, and 2 patients developed new onset hormonal deficiency. CONCLUSION: GKRS is a safe and effective modality for treatment of HH with significant improvement in seizure control with minimal disruption of endocrine profile. It provides an excellent safety, efficacy, and complication profile, especially for small HH. Latency of results and its adjuvant nature remain the areas of research and breakthroughs among contemporary treatment options.

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Safety and Efficacy of Primary Hypofractionated Gamma Knife Radiosurgery for Giant Hypothalamic Hamartoma

Cited by 7 publications

References 37 publications

Gamma Knife for Giant Hypothalamic Hamartomas—Not the Only Effective Tool in the Kit

Gamma Knife for Giant Hypothalamic Hamartomas—Not the Only Effective Tool in the Kit

Seizure outcomes and safety profiles of surgical options for epilepsy associated to hypothalamic hamartomas. A systematic review and meta-analysis

Gamma Knife Radiosurgery for Hypothalamic Hamartoma: A Multi-Institutional Retrospective Study on Safety, Efficacy, and Complication Profile

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