Discover the potential of two-staged gamma knife surgery in treating very large cerebellar metastases through our latest case series analysis, shedding light on innovative approaches in hematology.
– by Marv
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Is two-staged gamma knife surgery a reasonable management option for very large cerebellar metastases? A case series of three patients.
Lo et al., Acta Neurochir (Wien) 2024
<!– DOI: 10.1007/s00701-024-05974-7 //–>
https://doi.org/10.1007/s00701-024-05974-7
Oh, what a time to be alive! In the groundbreaking world of medical science, where the quest to push boundaries never sleeps, we’ve stumbled upon a riveting saga: the tale of treating gargantuan cerebellar metastases with not one, but two rounds of gamma knife surgery (GKS). Because, you know, why settle for a single round when you can double the fun?
Enter our brave subjects, four intrepid souls with cerebellar metastases that dared to exceed the audacious volume of 12 cm3. These aren’t just any tumors; these are the “go big or go home” kind, ranging all the way up to 30 cm3. And in the face of such daunting adversaries, our heroes opted for the two-staged GKS, a technique that whispers sweet nothings to very large tumors, promising a chance at redemption.
But wait, there’s a twist! Only three of our fearless four completed the treatment. The suspense is palpable. With doses of radiation that would make even the Hulk pause, 10-13 Gy, they embarked on this journey. And then, the waiting game began. Regular MRIs, clinical assessments, and the ever-exciting tumor volume measurements at every turn. The result? Tumor progression waved the white flag, not daring to show its face in any of the patients.
And the plot thickens – tumor volumes didn’t just decrease; they took a nosedive, shrinking by more than half. It’s like they decided to go on an extreme diet, vanishing before our very eyes. The median survival? A whopping 22 months. And in a dramatic turn of events, no one was taken by the cruel hand of intracranial tumor progression.
But what’s a story without a little drama? The initial peritumoral edema, a loyal sidekick to our villainous tumors, decided to bow out gracefully after the first GKS. In its place, a couple of patients were left with mild T2 changes, the kind that just hangs around, not doing much, certainly not enough to warrant any action.
And in the end, what have we learned? That staged GKS is not just a feasible option but perhaps the knight in shining armor for those facing the Goliath that is very large cerebellar metastases. So here’s to the brave souls and their gamma knives, slicing through the darkness, one precisely targeted radiation dose at a time.