Gamma Knife radiosurgery as salvage therapy for gangliogliomas after initial microsurgical resection

IntroductionGangliogliomas (GG) are considered WHO grade I rare tumors. While they commonly manifest as temporal lobe epilepsy, can be located anywhere in the brain. Primary treatment is complete microsurgical resection. Remnant or recurrent GG benefit from radiation therapy. Here, we present a series of who received Gamma Knife radiosurgery (GKR) after initial microsurgery.MethodsBetween October 2009 and February 2020, four patients benefitted such approach. The median age at surgery was 16 years (mean 17, 11–25) time GKR 22.5 23, 19–28). Initial clinical symptom epilepsy 3 cases incidental one. Biopsy firstly performed one case. One patient had stereotactic electroencephalography. respective anatomical locations were right parieto-occipital, sylvian, left paraventricular inferior parietal.ResultsGamma 3.5 gross total resection (GTR). follow-up 54 months 58.5, 6–120). marginal dose 18 Gy 17.5, 16–18). target volume 0.5 mL 0.904, 0.228–2.3). prescription isodose 0.6 0.9, 0.3–2.4). At last follow-up, majorly decreased patients, remained stable one.ConclusionGamma safe effective for remnant GTR. remains resection, especially with symptomatic mass effect epilepsy. Single fraction valuable option tumors