PURPOSE: When gamma knife radiosurgery (GKS) does not achieve control of the growth of a tumour, the need to repeat treatment is considered. The results and risks of repeat treatment of patients with a vestibular schwannoma were reviewed to assess its efficacy and safety. METHODS: Between 1992 and 2001, we treated 351 patients with a vestibular schwannoma by GKS, control of the growth of the tumour was not achieved in 32. 26 patients underwntrepeat GKS and five patients had an open microsurgical operation and one stereotactic aspiration of a tumour cyst. RESULTS: Twenty-four of 26 patients were followed up after the repeat GKS for a median of 43 months. 15 tumours became smaller, seven remained unchanged and two enlarged. After the second GKS one patient's hearing deteriorated, one developed facial weakness and three facial spasms. One patient required insertion of ventriculo-peritoneal drainage. An operation to radically resect the tumour was performed in five patients after the first GKS and for a subtotal removal in one after repeated GKS. CONCLUSIONS: In the small proportion of patients (9%) in whom initial GKS does not control the growth of a vestibular schwannoma, most can be controlled by further GKS with a very low risk of a complications.
- MeSH
- dospělí MeSH
- hodnocení rizik MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru epidemiologie chirurgie MeSH
- mladý dospělý MeSH
- nervus vestibularis patologie chirurgie MeSH
- neurochirurgické výkony statistika a číselné údaje MeSH
- percepční nedoslýchavost epidemiologie MeSH
- pooperační komplikace epidemiologie MeSH
- poranění nervus facialis epidemiologie MeSH
- radiochirurgie škodlivé účinky metody statistika a číselné údaje MeSH
- reoperace škodlivé účinky statistika a číselné údaje MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vestibulární schwannom patologie patofyziologie chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
