P.017 Efficacy of stereotactic intracavitary instillation of 90yttrium colloid for treatment of cystic sellar/parasellar tumors. (2nd June 2017)

• Record Type: Journal Article
• Authors: Clarke, DB; Hebb, AL; Hill, R; Imran, SA; Mishra, A; Mawko, G; Burrell, S
• Is Part Of: Canadian journal of neurological sciences. Volume 44(2017)Supplement 2
• Page Start: S18
• Page End: S18
• Publication Date: 2017-06-02
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Electronic journals; 616.8
• DOI: 10.1017/cjn.2017.102
• Languages: English
• ISSNs: 0317-1671

Abstract

Abstract : Background: Traditional neurosurgical techniques and/or stereotactic radiotherapy, although effective for solid tumors, can be associated with high morbidity and be relatively ineffective for long-term control of cystic sellar/parasellar tumors. The rationale of our study was to examine the efficacy and safety of stereotactic intracavitary instillation of 90 yttrium colloid for the primary treatment of cystic tumors.Methods: As part of a Health Canada approved clinical trial, we have enrolled nine patients (6 females, 3 males; mean age 64, range 43 to 83 years) for treatment of symptomatic and/or enlarging cysts. Ten cystic sellar/parasellar lesions underwent right frontal stereotactic insertion of 90 yttrium colloid to deliver a radiation dose of 200 Gy to the cyst wall.Results: Compared with pre-treatment cyst volumes (mean 4.6 cc; range 0.8-16.1 cc), the cysts decreased in size at 3 months (2.6 cc; 0.2-10 cc) with further shrinkage (n=5) at 9 months (1 cc; 0.1-2.7 cc). Of 9 patients with pre-operation visual field defects, 6 showed improvement. The single complication was a delayed (1 month) incomplete CNIII palsy.Conclusions: Our early experience indicates that 90 yttrium colloid delivered to a cystic craniopharyngioma provides an efficacious alternative to open surgery for primary treatment of these cystic lesions.