Complications after stereotactic radiosurgery in patients with brain disorders

Abstract

Objective: to analyze complications after stereotactic radiosurgery for various diseases performed using the Elekta Leksell Gamma Knife Perfexion.Materials and methods. This retrospective study of stereotactic radiosurgery outcomes included 3,148 patients with different brain lesions, including 1,621 individuals with metastases (51.5 %), 732 with meningiomas (23.3 %), 359 with neurinomas (11.4 %), 71 with arteriovenous malformations (2.3 %), 118 with cavernomas (3.7 %), 114 with neuroepithelial tumors (3.6 %), 46 with pituitary adenomas (1.5 %), 54 with functional diseases (1.7 %), and 33 with other diseases (1 %).The diagnosis was based on the results of neurological examination, magnetic resonance imaging, computed tomography, and positron emission tomography.The severity of radiation complications was evaluated using the Eastern Cooperative Oncology Group (ECOG) scale.Results. Among all patients who underwent stereotactic radiosurgery, 96 individuals developed 97 different complications. The most common complications included radionecrosis (n = 43) and perifocal edema (n = 38). Alopecia (n = 3) and increased frequency of epileptic seizures (n = 3) were less common. We observed very few specific complications, such as non-obstructive hydrocephalus (n = 3), cranial nerve lesions (n = 3), and endocrine disorders (n = 1). The total rate of radiation-induced complications was 3.08 %.Conclusion. Our findings suggest that stereotactic radiosurgery is a safe treatment for various brain diseases and is characterized by a low rate of postoperative complications. The incidence of postoperative complications in this study did not exceed that reported in Russian and foreign literature.