J Neurol Surg B Skull Base 2024; 85(S 01): S1-S398
DOI: 10.1055/s-0044-1779885
Presentation Abstracts
Oral Abstracts

Patterns of Response after Gamma Knife Radiosurgery in Cases of Cavernous Sinus Lesions

Authors

  • Nishanth Sadashiva

    1   National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India

  • Prabhuraj Ar

    1   National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India

  • Vikas Vazhayil

    1   National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India

  • Anand Kalgudi

    1   National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Introduction: Gamma Knife Radiosurgery (GKRS) is a commonly used modality for treating patients with cavernous sinus (CS) lesions. However, when treated primarily, making a diagnosis of either meningioma, hemangioma or schwannoma may be difficult. Response to these tumor types is different after GKRS and knowing response rates is crucial for Counselling patients about prognosis. Our aim was to evaluate the response in different tumor types.

Methods: We did a retrospective chart review of all patients who underwent GKRS for cavernous sinus tumor in our institute from 2006 to 2021. All patients with a minimum clinical and radiological follow-up of 6 months were included. Tumor control and clinical recovery was evaluated.

Results: 105 patients with CS tumors were treated in the study period. 17 patients were excluded due to unavailability of data. 38 were meningiomas, 8 schwannomas and 42 hemangiomas in the study. The median follow-up available was 22 months. Progression-free survival was 100% for cavernous sinus hemangiomas at a median follow-up of 38months, 96% for meningiomas at a median follow-up of 32months and 100% for schwannomas at a median follow-up of 30months. Cranial improvement was seen in all lesions with the fastest improvement seen in hemangiomas. When compared longitudinally, hemangiomas showed the most rapid response to treatment followed by Schwannomas. Complete disappearance of lesion happened only in hemangiomas compared to other tumor types.

Conclusion: Cavernous sinus hemangiomas have a rapid and complete response compared to schwannomas and meningiomas. The improvement in cranial nerve palsies happened faster and more dramatic. It is important to counsel patients according to their probable diagnosis rather than including all cavernous sinus lesions together. Radiologists play an important role in diagnosis based on imaging so that patients can be counselled accordingly.



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Artikel online veröffentlicht:
05. Februar 2024

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