CYBERKNIFE IN THE TREATMENT OF SPINALCORD TUMOURS

CYBERKNIFE IN THE TREATMENT OF SPINALCORD TUMOURS

When treating benign spinal tumors with radiosurgery, the primary intermediate objective is to stop all tumor growth. Over the long term, these tumors will gradually shrink in size which may take a period of several years. Preliminary results with CyberKnife radiosurgery for meningioma and schwannoma show excellent control of tumor growth.

Treatment with CyberKnife radiosurgery utilizing a hypofractionated treatment regimen was indicated for maximum local control and to minimize the chance of injury to the spinal cord.

Outcome and Follow-Up
At 3-month follow-up:
* Neck, shoulder and arm pain dramatically decreased
* Neck and left arm mobility much improved
* MRI study showed no progression of meningioma
9-month follow-up:
* Improved neck and left shoulder mobility
* Left arm strength increasing
* Some numbness in left upper arm but improved compared to last visit
12-month follow-up:
* Increased left shoulder and neck mobility
* Increased left arm function
* No new symptoms or problems
22-month follow-up:
* Left arm range of motion improved, arm strength stable,
mild residual weakness
* No new problems
* No neck pain
* Follow-up MRI reveals no evidence of tumor progression and stability
of the previously treated lesion
Conclusion
The patient has experienced significant improvement since undergoing stereotactic radiosurgery. MRI shows no evidence of tumor progression. Follow-up will occur on an annual basis with continued MRI surveillance.


SOURCE : http://www.utmedicalcenter.org/lib/file/manager/pages/cancer-institute/resources/-utmc-cyberknife-annual-report_011711.pdf


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CYBERKNIFE IN TREATMENT OF PITUITARY ADENOMAS

CYBERKNIFE IN TREATMENT OF PITUITARY ADENOMAS


In recent years, CyberKnife has emerged as an important treatment modality in the management of pituitary adenomas. Treatment results after performing CyberKnife and the complications of this procedure are reviewed.
Methods
Twenty-six patients with pituitary adenomas received stereotactic radiosurgery with the CyberKnife (CKRS). The follow-up periods ranged from 7 months to 47 months (mean±SD : 30±12.7 months). The patients consisted of 17 with non-functioning adenomas, 3 with prolactinomas and 6 with acromegaly. The change in the tumor volume, visual acuity, hormonal function, and complications by this therapy were analyzed in each case.
Results
The tumor control rate was 92.3%. Hormonal function was improved in all of the 9 (100%) functioning adenomas. Hormonal normalization was observed in 4 of the 9 (44%) patients with a mean duration of 16 months. In two patients (7.6%), visual acuity worsened due to cystic enlargement of the tumor after CKRS. No other complications were observed.
Conclusion
CyberKnife is considered safe and effective in selected patients with pituitary adenomas. However, longer follow-up is required for a more complete assessment of late toxicity and treatment efficacy.

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