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Radiosurgery with a Rotating Gamma System: A Very Effective Treatment for Symptomatic Cerebral Cavernomas.

AIM
To evaluate the value of radiosurgery with a rotating gamma-system (RGS) for cerebral cavernomas.


PATIENTS AND METHODS
Seventy-nine patients with symptomatic cerebral cavernomas underwent RGS radiosurgery at the Bach Mai Hospital, Hanoi, Vietnam. Median dose (single fraction) was 20 Gy (range=14-26 Gy). Endpoints included effect on headache, seizures and tumor size.


RESULTS
Of 60 patients with headache, 17% had complete response, 82% partial response and 2% stable disease (best response). Of 39 patients with seizures, 31% had complete response, 64% partial response and 5% stable disease. Four patients developed recurrent seizures after 1 year. Regarding the size of cavernoma at 15 months, complete response was observed in 6%, partial response in 75%, stable disease in 15%, progression in 1% and pseudo-progression in 3% of patients. Bleeding within 2 years after RGS radiosurgery occurred in only five patients (6%). RGS dose had no significant impact on outcomes.


CONCLUSION
RGS radiosurgery provided very high rates of symptom relief in patients with cerebral cavernomas.