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    Efficacy of stereotactic radiotherapy as salvage treatment for recurrent malignant gliomas
    (Imprimatur Publications, 2014) Ekici, Kemal; Ozsekee, Naciye; Mayadagli, Alpaslan; Kocak, Mihriban Erdogan; Olmezoglu, Ali
    Purpose: To evaluate the efficacy and toxicity of CyberKnife stereotactic radiotherapy (SRT) for recurrent glial tumors previously treated with high-dose radiotherapy. Methods: CyberKnife SRT was performed in 37 patients with recurrent glial tumors who presented to our hospital between January 2007 and March 2012. The patients were subjected to a dose ranging from 20 to 28 Gy using the CyberKnife system with an average of two fractions. The median follow-up duration after SRT was 14 months (range 1.8-57). Results: The median survival time of the patients after recurrence was 22.3 months (95% confidence interval/95% Cl 12.5-32). The median survival times of the high- and low-grade patients were 29 and 19 months, respectively. No significant toxicity due to radiation was noticed during the follow-up period. No factor influencing mortality was found in either the univari ate or multivariate analysis.. Conclusion: SRT using CyberKnife is an effective and safe treatment choice for recurrent glial tumors. SRT achieves a more favorable outcome in the treatment of recurrent tumors, particularly in high-grade ones
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    Fractionated stereotactic radiosurgery for vestibular schwannomas using cyberknife: A single institution experience
    (Pakistan Medical Assoc, 2016) Kocak, Mihriban Erdogan; Sengul, Adem; Ekici, Kemal; Olmezoglu, Ali; Seseogullari, Ozgur
    Objective: To assess tumour control, hearing preservation status, and complication ratio after fractionated stereotactic radiosurgery/radiotherapy by using CyberKnife device in patients with vestibular schwannomas. Methods: This retrospective study was conducted at Izmir Ataturk Research and Tranining Hospital, Turkey, and comprised data of vestibular schwannomas patients treated with stereotactic radiosurgery/radiotherapy from March 2010 to December 2013. The patients were subjected to a dose ranging from 12 to 30Gy using CyberKnife system with an average of three fractions. SPSS 17 was used for data analysis. Paired t-test and Pearson's chi-square test were used to compare clinical parameters between groups. P<0.05 was considered significant. Results: Of the 41 patients, 26(63.4%) were women and 15(36.6%) were men. The median follow-up duration after stereotactic radiosurgery/radiotherapy was 25 months (interquartile range: 9-44 months). Radiographic control evaluation ratio was 95.7% with a median follow- up of 3 years (IQR: 18.5 months). Results of 23(56%) patients showed stabile response, 17(42%) regression response and 1(2%) progression response. There were no statistically significant changes between pre- and post-stereotactic radiosurgery/radiotherapy symptoms (p>0.05). One (2.4%) patient reported new onset facial paresis. Conclusion: Stereotactic radiosurgery/radiotherapy treatment of vestibular schwannomas resulted in a good ratio of tumour control. Hearing preservation status and ratios of toxicity were comparable to published literature.