Summary
Stereotactic radiosurgery was applied to concentrate high dose of photon irradiation to tumors enclosed in the cavernous sinus. We have treated 10 meningiomas, five pituitary tumors, and three metastatic lesions in the past two years. Follow-up time ranges from 3 to 18 months with an average of 10 months. Tumor volume ranged from 0.92 to 53.31 cc with an average 10.79 cc. CT scans and MRIs were used to demonstrate the tumor relationship to cranial nerves and structures of the brain. One to 6 isocenters were used. Collimator size varied from 7 to 28 mm, and the dose to the margin of the tumor ranged from 1400 to 2500 cGy with an average of 1650 cGy. Maximal dose range of 1575 to 5000 cGy. The margin of the tumor was encompassed within the 50 to 95% isodose volume with an average treatment prescribed to the 57% isodose volume. Symptomatic response was seen in 12 patients, and stabilization of symptoms in three patients with progression of symptoms observed in three patients. Radiographic imaging revealed response in eight patients, unchanged in three patients and progression in three patients. This report shows the feasibility of applying linear accelerator radio-surgery to the treatment of cavernous sinus tumors. This form of therapy promises to play an important role in complementing tumor resection.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Al-Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22: 510–517
Al-Mefty O, Smith RR (1988) Surgery of tumors invading the cavernous sinus. Surg Neurol 30: 370–381
Barbaro NM, Gutin PH, Wilson CB, Sheline GE (1987) Radiation therapy in the treatment of partially resected meningiomas. Neurosurgery 20: 525–528
Carella RJ, Ransohoff J, Newall J (1982) Role of radiation therapy in the management of meningioma. Neurosurgery 10: 332–339
De Salles AAF, Asfora WT, Abe M, Kjellberg RN (1987) Transposition of target information from the magnetic resonance and computed tomography scan images to conventional x-ray stereotactic space. Appl Neurophysiol 50: 23–32
Dolenc V (1983) Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 58: 824–831
Flickinger JC, Lunsford LD, Coffey RJ (1991) Radiosurgery of acoustic neuromas. Cancer 67: 345–353
Friedman WA, Bova FJ (1989) The University of Florida radio-surgery system. Surg Neurol 32: 334–342
Goetsch SJ, De Salles AAF, Holly FE (1992) Treatment planning for stereotactic radiosurgery with linear accelerators. J Neurosurg (submitted)
Guy J. Mancuso A, Beck R (1991) Radiation-induced optic neuropathy: A magnetic resonance imaging study. J Neurosurg 74: 426–432
Harrison MJ, Wolfe DE, Lau T-S (1991) Radiation-induced meningiomas: Experience at the Mount Sinai Hospital and review of the literature. J Neurosurg 75: 564–574
Kondziolka D, Lunsford LD (1991) Stereotactic radiosurgery for squamous cell carcinoma of the nasopharynx. Laryngoscope 101: 519–522
Kondziolka D, Lunsford LD, Coffey RJ (1991) Stereotactic radio-surgery of meningiomas. J Neurosurg 74: 552–559
Kondziolka D, Lunsford LD, Flickinger JC (1991) The role of radiosurgery in the management of chordoma and chondrosarcoma of the cranial base. Neurosurgery 29: 38–46
Kooy HM, Nedzi LA, Loeffler JS (1991) Treatment planning for stereotactic radiosurgery of intracranial lesions. Intl Radiation Oncol Biol Phys 21: 683–693
Leksell L (1971) A note on the treatment of acoustic neuromas. Acta Chir Scand 137: 763–765
Mayberg MR, Symon L (1986) Meningiomas of the clivus and apical petrous bone. Report of 35 cases. J Neurosurg 65: 160–167
Ojemann RG (1992) Skull-base surgery: A perspective. J Neuro-surg 76: 569–570
Samii M, Ammirati M, Mahran A (1989) Surgery of petroclival meningiomas: Report of 24 cases. Neurosurgery 24: 12–17
Sekhar LN, Pomeranz S, Janecka IP (1992) Temporal bone neoplasms: A report on 20 surgically treated cases. J Neurosurg 76: 578–587
Sekhar LN, Sen CN, Jho HD, Janecka IP (1989) Surgical treatment of intracavernous neoplasms: A four-year experience. Neurosurgery 24: 18–30
Spetzler RF, Daspit CP, Pappas CTE (1992) The combined supra-and intratentorial approach for lesions of the petrous and clivai regions: Experience with 46 cases. J Neurosurg 76: 588–599
Taylor BW, Marcus RB, Friedman WA (1988) The meningioma controversy: Postoperative radiation therapy. J Rad Oncol Biol Phys 15: 299–304
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer-Verlag Wien
About this paper
Cite this paper
De Salles, A.A.F. et al. (1993). Radiosurgery of Cavernous Sinus Tumors. In: Meyerson, B.A., Broggi, G., Martin-Rodriguez, J., Ostertag, C., Sindou, M. (eds) Advances in Stereotactic and Functional Neurosurgery 10. Acta Neurochirurgica, vol 58. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9297-9_23
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9297-9_23
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-9299-3
Online ISBN: 978-3-7091-9297-9
eBook Packages: Springer Book Archive