Stereotactic radiosurgery for orbital cavernous hemangiomas

J Neurosurg. 2022 Oct 7;138(6):1622-1629. doi: 10.3171/2022.8.JNS221222. Print 2023 Jun 1.

Abstract

Objective: The goal of this study was to assess the safety and efficacy of single-session Gamma Knife radiosurgery (GKRS) for orbital cavernous hemangiomas (OCHs).

Methods: Patients who presented with an OCH between September 1999 and May 2022 and were treated with single-session GKRS were included in this single-center cohort study.

Results: There were 23 patients (7 males and 16 females) in this study. The median margin dose was 12 Gy (range 11-13 Gy). The median clinical and radiological follow-ups were 45 months (range 5-190 months) and 45 months (range 6-190 months), respectively. Nine (69.2%) of 13 patients with visual acuity impairment had improvement in best corrected visual acuity. Of the 8 patients with visual field defects, 5 patients (62.5%) had complete resolution. Tumor regression was observed in 22 patients (95.7%). The mean relative reduction in tumor volume was 82.6% ± 23.7%. The relative reductions in tumor volume were 33%, 49%, 72%, 84%, and 89% at 6, 12, 24, 36, and 48 months, respectively. Adverse effects of radiation were not observed.

Conclusions: GKRS appears to be safe and efficacious for treating OCHs over long-term follow-up. The treatment is associated with a high rate of regression in OCHs and remarkable improvement in both visual acuity and visual field deficits.

Keywords: Gamma Knife; hemangioma; orbital; progression-free survival; stereotactic radiosurgery.

MeSH terms

  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hemangioma, Cavernous* / diagnostic imaging
  • Hemangioma, Cavernous* / radiotherapy
  • Hemangioma, Cavernous* / surgery
  • Humans
  • Male
  • Radiosurgery* / adverse effects
  • Retrospective Studies
  • Treatment Outcome