Follow-up observation of gamma knife radiosurgery for cavernous sinus cavernous hemangioma

Wang Jianfeng; Liu Huali; Meng Xijun; Li Wentao; Ren Chunying; Xia Ming; Dan Yong

doi:10.11850/j.issn.1009-122X.2025.02.004

Abstract：Objective To evaluate the safety and efficacy of Gamma Knife radiosurgery(GKS)in the treatment of cavernous sinus cavernous hemangioma(CSH).Methods The clinical data of 26 patients with CSH were analyzed retrospectively.There were 5 males(19%),21 females(81%),with an average age of 53 years(35-78 years),12 cases confirmed by surgery,and 14 confirmed by imaging before GKS.All the patients were treated with the Perfexion Gamma Knife.Before GKS,16(61%)had cranial nerve symptoms,12 had headache and dizziness,and 2 had no obvious symptoms.The volume of CSH before GKS was 2.02-106.3 cm3(average 19.36cm3),and the marginal dose was 6-15Gy(average 12.9Gy).Four patients with larger lesions underwent fractionated treatment.The 22 patients were divided into the operation group(n=10)and the non-operation group(n=12).There were 7 cases(6-12Gy)in the marginal low-dose group and 15 cases(13-15Gy)in the high-dose group,and univariate multivariate ANOVA was used to assess the CSH control rate.Results The follow-up period ranged from 3 to 73 months(average 18.2 months),and the response rate was 100%,includingn significant efficacy in 25 patients(96%)and certain efficacy in 1(4%).One patient with lesions on the left side had decreased vision in the right eye and one had epilepsy.After GKS,the cranial nerve symptoms were alleviated to varying degrees.CSH shuttered rapidly at 3-12 months after GKS,and increased the tumor control rate with time change in 24-36 months,but with the extension of follow-up time,the tumor control rate did not improve significantly.Neither prior surgery nor higher marginal doses significantly improved tumor control rates.Conclusions GKS is effective and safe in the treatment of CSH,and can be used as a minimally invasive alternative to clinical craniotomy.