Treatment of Intracranial Tumors With Stereotactic Radiosurgery: Short-Term Results From Cuba

Amaya Alvarez Aquino; Manuel de Jesus Encarnacion Ramirez; Ismail Bozkurt; José Antonio Asprilla González; Evgeniy Goncharov; Ana D Caballero; Renat Nurmukhametov; Nicola Montemurro; Bipin Chaurasia

doi:10.7759/cureus.29955

Treatment of Intracranial Tumors With Stereotactic Radiosurgery: Short-Term Results From Cuba

Cureus. 2022 Oct 5;14(10):e29955. doi: 10.7759/cureus.29955. eCollection 2022 Oct.

Authors

Amaya Alvarez Aquino¹, Manuel de Jesus Encarnacion Ramirez², Ismail Bozkurt³, José Antonio Asprilla González⁴, Evgeniy Goncharov⁵, Ana D Caballero⁶, Renat Nurmukhametov⁷, Nicola Montemurro⁸, Bipin Chaurasia⁹

Affiliations

¹ Neurosurgery, International Center of Neurological Restoration (CIREN), Havana, CUB.
² Neurological Surgery, Peoples' Friendship University of Russia, Moscow, RUS.
³ Neurosurgery, Cankiri State Hospital, Çankırı, TUR.
⁴ Neurosurgery, Sheba Medical Center, Tel HaShomer Hospital, Tel Aviv, ISR.
⁵ Traumatology and Orthopedics, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, RUS.
⁶ Neurosurgery, Tyumen State University, Moscow, RUS.
⁷ Neurosurgery, Peoples' Friendship University of Russia, Moscow, RUS.
⁸ Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, ITA.
⁹ Neurosurgery, Bhawani Hospital and Research Center, Birgunj, NPL.

Abstract

Background Although international publications on radiosurgery have increased exponentially, reports of heterogeneous series treated with linear accelerator (LINAC) are scarce. Since most intracranial tumors are irregular in size and not spherical, LINACs (Elekta Precise®, Elekta AB, Sweden), fitted with a multi-leaf collimator, allow for precise stereotactic radiosurgery for the entire tumor. Aim To evaluate the effects of LINAC on an outpatient basis with patients diagnosed with various intracranial malignancies. Methodology A retrospective observational study of a series of cases of patients with intracranial lesions treated at the Institute of Oncology and Radiobiology using LINAC was carried out from October 2019 to May 2021 to evaluate the therapeutic results of radiosurgery in patients with intracranial tumors. Results A total of 22 lesions in 20 patients were treated with LINAC. The average age of the patients was 49.7, and the male-female ratio was 1:2. The cases consisted were mostly vestibular schwannoma (7 lesions), metastases from breast cancer (3 lesions), and tuberculum sellae meningioma (2 lesions). The prescription dose covered 99% of the planning target volume in 16 lesions (72.7%) and 100% in six lesions (27.3%) (prescription volume). In meningiomas and schwannomas, doses between 12 and 14 Gy were used, in plasmacytoma 13 Gy, in pilocytic astrocytoma 14 Gy, in cavernoma 15 Gy, in breast cancer metastasis between 18 and 20 Gy, and in lung cancer metastasis 22 Gy. When evaluating local control, 11 patients exhibited stable findings at the six-month control while 10 had partial regression, and a single patient had total regression. Minor complications such as perilesional edema, facial paresthesia, facial paralysis, and transient alopecia were observed in eight of the patients. Conclusions Patients with extra-axial, low-grade malignancy, and posterior fossa lesions were predominant in the studied population. Radiosurgery treatment is associated with good local control of the treated lesions. Complications are infrequent, mild, and predominated by perilesional edema.

Keywords: brain tumors cns tumors; cranial tumors; linac based radiosurgery; meningioma; stereotactic radiosurgery srs.