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Titolo:
Neurofibromatosis type 2. Preliminary results of gamma knife radiosurgery of vestibular schwannomas
Autore:
Roche, PH; Regis, J; Pellet, W; Thomassin, JM; Gregoire, R; Dufour, H; Peragut, JC;
Indirizzi:
CHU Timone, Serv Neurochirurg Stereotax & Fonct, F-13385 Marseille 05, France CHU Timone Marseille France 05 tax & Fonct, F-13385 Marseille 05, France CHU Timone, Federat Otorhinolaryngol, F-13385 Marseille, France CHU Timone Marseille France F-13385 olaryngol, F-13385 Marseille, France CH St Marguerite, Serv Neurochirurg, F-13274 Marseille 09, France CH St Marguerite Marseille France 09 irurg, F-13274 Marseille 09, France CH St Marguerite, Dept Med Informat, F-13274 Marseille 09, France CH St Marguerite Marseille France 09 ormat, F-13274 Marseille 09, France CH La Timone, Serv Neurochirurg, Marseille, France CH La Timone Marseille France one, Serv Neurochirurg, Marseille, France
Titolo Testata:
NEUROCHIRURGIE
fascicolo: 4, volume: 46, anno: 2000,
pagine: 339 - 353
SICI:
0028-3770(200009)46:4<339:NT2PRO>2.0.ZU;2-E
Fonte:
ISI
Lingua:
FRE
Soggetto:
FRACTIONATED STEREOTACTIC RADIOSURGERY; BILATERAL ACOUSTIC TUMORS; FACIAL-NERVE; HEARING PRESERVATION; LINEAR-ACCELERATOR; NEUROMA SURGERY; MANAGEMENT; MICROSURGERY; NEURINOMAS;
Keywords:
facial nerve palsy; gamma knife; hearing preservation; neurofibromatosis type 2; stereotactic radiosurgery; vestibular schwannoma;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Regis, J CHU Timone, Serv Neurochirurg Stereotax & Fonct, 264 Rue St Pierre, F-13385 Marseille 05, France CHU Timone 264 Rue St Pierre Marseille France 05 ille 05, France
Citazione:
P.H. Roche et al., "Neurofibromatosis type 2. Preliminary results of gamma knife radiosurgery of vestibular schwannomas", NEUROCHIRE, 46(4), 2000, pp. 339-353

Abstract

Background and purpose. - The aim of this study was to assess tolerance and efficacy of gamma knife radiosurgery on vestibular schwannomas for patients affected with neurofibromatosis type 2. Methods. - Between July 1992 and December 1997, a gamma knife procedure was performed on 35 vestibular schwannomas affecting 27 patients (12 females and 15 males, mean age = 27 years-old, range: 14-65). Fifteen of the patients were included in the Wishart subtype (severe form) and 12 patients in the Gardner subtype (mild form). This group of 27 patients represented 8,2 % of the total group of vestibular schwannomas radiosurgically treated by ourteam. The mean tumor volume was 4 000 mm(3) (range : 400-14 400 mm(3)) andstaging according to Koos classification was 9 stade 2 tumors (extension in the cerebellopontine angle), 19 stade 3 tumors (in contact with the brainstem or cerebellum) and 7 stade 4 tumors (compression of axial structures). The delivered mean marginal dose (50 % isodose) was 13 Gy (range: 10-18 Gy). After the treatment, the mean clinical and radiological follow-up was 32 months (range: 6-70). Results. - Twenty six (74 %) of the treated tumors were controlled by the treatment (15 stabilisations and II regressions of the tumor volume) at last follow-lip. One microsurgical removal was required in a growing stade 4 tumor and in 2 cases of growing stade 3 tumors. Three post-radiosurgical facial nerve deficits (9 %) were observed, 2 of them were transient. Accordingto the Gardner and Robertson classification, classes I (good) and II (serviceable) hearing were preserved at last follow-rip in 57 % of the patients having the same hearing level prior to the gamma knife. Conclusions. - Our experience confirms that tolerance of gamma knife radiosurgery compares favorably with microsurgery of bilateral vestibular schwannomas. This treatment should be restricted to small and medium growing tumors. Treatment strategy of neurofibromatosis type 2 patients should be planned by multidisciplinary experienced teams disposing of the whole armamentarium A longer follow-lip study is required to confirm the current results regarding the tumor control rate.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 09:53:08