The Effectiveness of the Prescribed Dose of the Gamma Knife Radiosurgery in Treating Low Grade Glioma
Keywords:
Gamma Knife, Radiosurgery, GKRS, Low Grade Glioma, Glioma, Radiation DoseAbstract
The most prominent form of primary intracerebral tumor is gliomas. Their incidence ranges between 45% and 62% of the population, with a slight prevalence in males (M/F: 1.3). Gliomas are tumors that develop from glial or precursor cells that are neuroectodermal in origin. Gliomas account for 75% of malignant primary brain tumors in adults, with glioblastomas accounting for more than half of glioma. While CNS tumors are rare, they are a significant cause of cancer morbidity and mortality, especially in children and young adults, where they account for roughly 30% and 20% of cancer deaths, respectively. They still have a high death rate compared to other cancers. This benign tumor (WHO Grade I) is mainly found in children and has biological features that differ from diffuse astrocytomas (WHO Grades II-IV). Glioma cells' ability to migrate is a key factor in making glial tumors aggressive. Contrast enhancement cannot distinguish between high- and low-grade gliomas, but low-grade gliomas are considered nonenhancing tumors. Alokaili et al. discovered that 35% of low-grade gliomas improved, while only 16% of high-grade gliomas did not. This study included 75 patients with low-grade glioma; however, due to the spread of Covid-19, some patients were unable to finish the follow-up therefore, they were removed from the total number that became later (31) patients. In the final analysis, (31) people participated in this study, conducted at the Gamma knife center of Neurosciences Hospital, Baghdad/Iraq seven months from June to December, with prescribed doses at 50% from 12Gy to 20Gy. Some patients did the gamma knife radiosurgery before this study begins, but they are included in this study because they are under follow up, and this study needed to do a follow up after one-year post-gamma or more, so will found that there are some of them with a follow up after 2years, 3years post-gamma knife radiosurgery, The follow-up includes MRIs for all patients who were treated at the neuroscience hospital, as well as measurements of tumor size before and after GK for all patients. In all age groups there was a decrease in the average tumor volume after radiosurgery. The highest average tumor volume in the 40-49 age group before radiosurgery. The p-value is significant ≤0.001. The highest rate of improvement in tumor size was in the age group 40-49. The average tumor size in females is greater than the average tumor size in males before radiosurgery. After radiosurgery, the average tumor size in females was lower than in males. The average difference between tumor size before and after GKR and that the rate of decrease in tumor size in females is more than males, p-value was significant (p-value= 0.038)It was found that the tumor volume rates in those who underwent previous surgery were higher than in patients who did not undergo previous surgery. The date of prior surgery is a significant (p-value = 0.046).It is clear that a larger dose was given to patients with a larger tumor size, and that the dose (12 Gy) was the lower effective as the tumor size increased, and the lowest tumor size after radiosurgery was in 2020. That the amount of decrease in tumor size increased relatively with increasing dose, and that the lowest rate of decrease in tumor size was in the lowest dose amount.
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