Toxicity of Gamma Knife radiosurgery in the treatment of intracranial tumors in patients with collagen vascular diseases or multiple sclerosis

Dot Lowell, Stephen B. Tatter, J. Daniel Bourland, Allan F. Deguzman, Kenneth E. Ekstrand, Thomas L. Ellis, James F. Lovato, Kevin P. McMullen, Michael T. Munley, Edward G. Shaw, James J. Urbanic, Michael D. Chan

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: To assess toxicity in patients with either a collagen vascular disease (CVD) or multiple sclerosis (MS) treated with intracranial radiosurgery. Methods and Materials: Between January 2004 and April 2009, 6 patients with MS and 14 patients with a CVD were treated with Gamma Knife radiosurgery (GKRS) for intracranial tumors. Treated lesions included 15 total brain metastases in 7 patients, 11 benign brain tumors, 1 low grade glioma, and 1 cavernous malformation. Toxicities were graded by the Radiation Therapy Oncology Group Acute/Late Radiation Morbidity Scoring Criteria. "Rare toxicities" were characterized as those reported in the scientific literature at an incidence of 3 (range, 0.14-7.8 cm 3). Of the 14 patients with CVD, none experienced a Grade 3 or 4 toxicity or a toxicity characterized as rare. Of the 6 patients with MS, 3 experienced rare toxicities, and two of these were Grade 3 toxicities. Rare complications included a patient experiencing both communicating hydrocephalus and facial nerve palsy, as well as 2 additional patients with motor cranial nerve palsy. High-grade toxicities included the patient with an acoustic neuroma requiring ventriculoperitoneal shunt placement for obstructive hydrocephalus, and 1 patient with a facial nerve schwannoma who experienced permanent facial nerve palsy. Interval between radiosurgery and high-grade toxicities ranged from 1 week to 4 months. Conclusions: Our series suggests that patients with MS who receive GKRS may be at increased risk of rare and high-grade treatment-related toxicity. Given the time course of toxicity, treatment-related edema or demyelination represent potential mechanisms.

Original languageEnglish (US)
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number4
DOIs
StatePublished - Nov 15 2011
Externally publishedYes

Fingerprint

Collagen Diseases
Radiosurgery
Arteriosclerosis
collagens
Vascular Diseases
toxicity
Multiple Sclerosis
tumors
grade
Neoplasms
nerves
Facial Nerve
Therapeutics
Facial Paralysis
Hydrocephalus
brain
Literature
Cranial Nerve Diseases
Ventriculoperitoneal Shunt
edema

Keywords

  • Collagen vascular disease
  • Multiple sclerosis
  • Radiosurgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Toxicity of Gamma Knife radiosurgery in the treatment of intracranial tumors in patients with collagen vascular diseases or multiple sclerosis. / Lowell, Dot; Tatter, Stephen B.; Bourland, J. Daniel; Deguzman, Allan F.; Ekstrand, Kenneth E.; Ellis, Thomas L.; Lovato, James F.; McMullen, Kevin P.; Munley, Michael T.; Shaw, Edward G.; Urbanic, James J.; Chan, Michael D.

In: International Journal of Radiation Oncology Biology Physics, Vol. 81, No. 4, 15.11.2011.

Research output: Contribution to journalArticle

Lowell, D, Tatter, SB, Bourland, JD, Deguzman, AF, Ekstrand, KE, Ellis, TL, Lovato, JF, McMullen, KP, Munley, MT, Shaw, EG, Urbanic, JJ & Chan, MD 2011, 'Toxicity of Gamma Knife radiosurgery in the treatment of intracranial tumors in patients with collagen vascular diseases or multiple sclerosis', International Journal of Radiation Oncology Biology Physics, vol. 81, no. 4. https://doi.org/10.1016/j.ijrobp.2011.02.056
Lowell, Dot ; Tatter, Stephen B. ; Bourland, J. Daniel ; Deguzman, Allan F. ; Ekstrand, Kenneth E. ; Ellis, Thomas L. ; Lovato, James F. ; McMullen, Kevin P. ; Munley, Michael T. ; Shaw, Edward G. ; Urbanic, James J. ; Chan, Michael D. / Toxicity of Gamma Knife radiosurgery in the treatment of intracranial tumors in patients with collagen vascular diseases or multiple sclerosis. In: International Journal of Radiation Oncology Biology Physics. 2011 ; Vol. 81, No. 4.
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AU - Deguzman, Allan F.

AU - Ekstrand, Kenneth E.

AU - Ellis, Thomas L.

AU - Lovato, James F.

AU - McMullen, Kevin P.

AU - Munley, Michael T.

AU - Shaw, Edward G.

AU - Urbanic, James J.

AU - Chan, Michael D.

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