Keywords : Stereotactic radiosurgery

Effect of Gamma Knife Radiosurgery in Meningioma

Iraqi Postgraduate Medical Journal, 2019, Volume 18, Issue 2, Pages 107-114

Meningioma is a common disease affects middle age patients especially females. Surgery is the first choice of treatment, gamma knife usually is a treatment for residual tumor or sometimes initially when surgery is risky.
To evaluate the short time effectiveness of gamma knife in treatment of meningioma with associated complications including necrosis and edema and assessing factors that favor success PATIENTS AND METHODS:
A retrospective study from April 2017 to October 2017 in Neurosciences hospital of 35 patients, 25 female and 10 male, age range 36-70 years, brain MRI done before and 6 months after gamma knife, patients evaluated regarding type of meningioma, number of shots, edema and radiation dose
The most common types were parasagittal and convexity meningioma, size of tumors ranged from 10mm to 57mm most tumors were 20-29mm, post-gamma necrosis was higher in non-basal meningioma (76.5%) than basal meningioma (44.4%). Necrosis appeared 100% when using > 18 Grey. The necrosis decreased when using doses 14-16 Grey and 10-12 Grey. Non-basal meningioma showed high edema (47.1%) while basal showed less edema (38.9%), higher doses of radiation associated with more edema. Headache improved post-gamma.
Gamma knife is effective and safe option to treat meningioma when surgery is risky, the tumor necrosis is highest in non-basal meningioma and when the dose above 14 grey and the peritumoral edema was highest also in non-basal meningioma and when the dose of radiation above 18 grey.
KEYWORDS: Meningioma, Gamma knife surgery, Stereotactic radiosurgery

Outcomes of Gamma Knife Surgery in the Treatment of Patients with Metastatic Brain Tumors

Iraqi Postgraduate Medical Journal, 2019, Volume 18, Issue 1, Pages 1-9

Cerebral metastases are by far the most common intracranial tumors in adults. gamma knife
radiosurgery has arguably been the most important advancement in the management of metastatic
brain tumors since the 1980s.
To evaluate the effectiveness of gamma knife radiosurgery as a treatment of metastatic brain
This is a prospective study (the first trial in Iraq) of 27 patients (42 tumors) of brain metastasis
between March 2016 and October 2017. Imaging follow up done in 6 months and 12 months,
clinical follow up done in 3 weeks and 3 months.
In the first six months 81.0% of the MBTs were regressed or remain stable in size. After 3
months post GKS, 81.5% patients showed neurological improvement. 82.4% of the patients<65
years old survive for 12 months and 85% of patients with KPS>70 survive for 12 months.
The routine blood investigations, the gender and the location were of no significance on patients’
general outcome or the tumor/edema response to gamma knife. Presence of extracranial
metastasis, single or multiple MBTs found to have important effect on patients’ survival.