Author Topic: GK success rate  (Read 6119 times)

Agate

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GK success rate
« on: October 05, 2009, 08:51:25 am »
I am a 62 year old recently diagnosed with 2cm right sided acoustic neuroma.  Have been to several doctors and have done alot of research online and on this forum.   I am extremely active right now as I only have some hearing loss (still have 100 percent word recognition) and of course the ringing which I have gotten used to.   It has been quite a rollercoaster ride trying to make the right decision that will give me the best quality of life
 
Does anyone know how different hospitals actually measure sucess for GK.  Pittsburg claims that they typically achieve long term inactivation of growth and hopefully shrinkage over time in 98% of patients.  The Mayo claims that they are only able to do that in 90 - 93% of their patients. 

Thanks for your help. 

Mickey

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Re: GK success rate
« Reply #1 on: October 05, 2009, 10:01:44 am »
I`m a 61 year old with a 1.2X.06 left sided AN. I`ve been W+W for over 2years now without any growth. I also have minimal symptoms. I`ve decided if my tumor has reach its maturity I`m not doing anything other than trying to stay healthy. There are many options which are all good with today`s technology. Whatever your choice I`m sure you will be fine. GK may sit with me if my condition changes. Best wishes , Mickey

Jim Scott

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Re: GK success rate
« Reply #2 on: October 05, 2009, 03:27:04 pm »
Hello - and welcome, Agate ~

I believe that GK success is based on a cessation of tumor growth following the radiation procedure, usually referred to as 'stabilization'.  A success rate in the 90 percentile range is typical and probably accurate.  At this point in time, no procedure is going to have a 100% success rate, so we look for the best 'odds' of success  (no further growth) that are available. Pittsburgh's 90 - 98%  success rate - even if a tad optimistic,- is excellent.  Frankly, any facility with a success rate  (on ANs) of 90% or above is certainly worth considering.  However, until and unless your symptoms increase, Watch-And-Wait may be your best option.  Only you (and your doctor) can make that decision. 

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

mk

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Re: GK success rate
« Reply #3 on: October 05, 2009, 05:26:15 pm »
Hello and welcome,

I would say that the best way to probe the success rate of GK is to look into published peer-reviewed studies (some of which by the way have been authored by Pittburgh and other reputable institutions internationally). Given that GK machines and procedures are pretty established nowadays, there shouldn't be a big difference depending on the institution. Based on what I have seen in the medical literature, success rates of around 88 - 95% are reported, depending on the study. The success rates may depend on the initial volume of the AN treated, radiation dose etc (older studies use higher radiation doses).  So some variability is inevitable.
If you are interested I can try to dig out the latest study I have seen from Pittsburgh.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

Agate

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Re: GK success rate
« Reply #4 on: October 05, 2009, 08:37:54 pm »
Thank you.  I would be interested in seeing the latest study you have seen from Pittsburg.   We have not talked to the doctor from Pittsburg yet but he has reviewed my MRI and sent out a letter stating that he thought I would be a good candidate for GK but then it is a GK center.  His letter states that long term inactivation of the growth and hopefully shrinkage of the tumor is typically achieved in 98% of patients.  That just seems like an awful high percentage.   I'm in MN and Mayo is a really good hospital with a wonderful reputation and they don't have those kind of numbers. 

sgerrard

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Re: GK success rate
« Reply #5 on: October 06, 2009, 12:44:15 am »
There is a some disagreement about the best way to measure success with radiation treatment. Some argue that it is best to count only those cases where the AN is no bigger than it was at treatment; others prefer to include those cases where there is a little more growth, but no further treatment is needed. GM on this forum is an example of the latter; his AN got a little bigger, but it is now stable, and there is no plan to treat it again.

Dr. Kondziolka from Pittsburgh was quite emphatic at the symposium that their success rate is solidly 98% now. I believe he uses in no further treatment needed as a measure of success. I wouldn't worry too much about the small differences in numbers; just make sure you are in the 90+% group where ever you go.  ;)

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

mk

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Re: GK success rate
« Reply #6 on: October 08, 2009, 08:00:46 am »
Sorry for the delay, but as promised here is the abstract from the latest and most comprehensive study from Pittburgh, published in 2005.
I have the full article as well, if you are interested please PM me with your e-mail address.


Marianna

Radiosurgery of vestibular schwannomas: summary of
experience in 829 cases
L. DADE LUNSFORD, M.D., AJAY NIRANJAN, M.B.B.S, M.S., JOHN C. FLICKINGER, M.D.,
ANN MAITZ, M.SC., AND DOUGLAS KONDZIOLKA, M.D., F.R.C.S.
Departments of Neurological Surgery and Radiation Oncology, The University of Pittsburgh School of
Medicine; and The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Object. Management options for vestibular schwannomas (VSs) have greatly expanded since the introduction of
stereotactic radiosurgery. Optimal outcomes reflect long-term tumor control, preservation of cranial nerve function,
and retention of quality of life. The authors review their 15-year experience.
Methods. Between 1987 and 2002, some 829 patients with VSs underwent gamma knife surgery (GKS). Dose selection,
imaging, and dose planning techniques evolved between 1987 and 1992 but thereafter remained stable for 10
years. The average tumor volume was 2.5 cm3. The median margin dose to the tumor was 13 Gy (range 10–20 Gy).
No patient sustained significant perioperative morbidity. The average duration of hospital stay was less than 1 day.
Unchanged hearing preservation was possible in 50 to 77% of patients (up to 90% in those with intracanalicular
tumors). Facial neuropathy risks were reduced to less than 1%. Trigeminal symptoms were detected in less than 3%
of patients whose tumors reached the level of the trigeminal nerve. Tumor control rates at 10 years were 97% (no additional
treatment needed).
Conclusions. Superior imaging, multiple isocenter volumetric conformal dose planning, and optimal precision and
dose delivery contributed to the long-term success of GKS, including in those patients in whom initial microsurgery
had failed. Gamma knife surgery provides a low risk, minimally invasive treatment option for patients with newly diagnosed
or residual VS. Cranial nerve preservation and quality of life maintenance are possible in long-term follow up.
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

Agate

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Re: GK success rate
« Reply #7 on: October 09, 2009, 11:40:09 am »
Thank you.  I have read most of your posts and you do a nice job explaining things.  I'm scheduled for my Gamma Knife in Pittsburg with Dr. Kondziolka in a couple of weeks.  I hope that I have read enough that I will be able to handle and understand and not panic when some of the things pop up after the treatment. 

mk

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Re: GK success rate
« Reply #8 on: October 09, 2009, 02:17:13 pm »
Best wishes for your treatment.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

GM

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Re: GK success rate
« Reply #9 on: October 11, 2009, 04:27:28 pm »
Agate,

At the bottom of my post are a few more GK links....

GM
Originally 1.8cm (left ear)...Swelled to 2.1 cm...and holding after GK treatment (Nov 2003)
Gamma Knife University of Virginia  http://www.medicine.virginia.edu/clinical/departments/neurosurgery/gammaknife/home-page
Note: Riverside Hospital in Newport News Virginia now has GK!!

eab

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Re: GK success rate
« Reply #10 on: October 21, 2009, 09:45:00 am »
Good luck with your treatment! I am 3 months out from GK and thus far have had no side effects.  From the research and other posts on this site I've found it's clear that side effects can kick in any time now or not at all so I'm just taking it one day at a time and enjoying all of the side effect-free days that I have.

I hope you have a similarly smooth experience!
Again, good luck - there's not much to it just sit back and find your happy place.  The doctors and machines do all the work.
Beth

Left side AN 2.5x1.7x1.5cm, limited hearing loss, limited tin., good balance
GK 7/6/09 Hoag Hospital; MRIs at 2, 6 & 12 months show no change in tumor size - hearing etc. same as before GK.

Agate

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Re: GK success rate
« Reply #11 on: October 27, 2009, 03:05:22 pm »
Thanks - my GK surgery went very well - they must have really sedated me because it's only been a week and I hardly remember a thing.  It's nice to hear that you are doing well.  Hope it continues because it's nice to hear success stories.  I am 62 so certainly older than you, but my tumor was about the same size.  My symptoms were a slight ringing in my ear and slight hearing loss.  I'm having some shooting pains in my ear right now - the doctors really didn't tell me what to expect.  I've learned an awful lot on this forum. 

I think now that we try and forget about it and deal with side affects IF and when they happen. 

Jim Scott

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Re: GK success rate
« Reply #12 on: October 27, 2009, 03:12:11 pm »
Agate ~

Congratulations on your successful GK treatment!  Side effects? What side effects?  ;)

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

Vivian B.

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Re: GK success rate
« Reply #13 on: November 02, 2009, 06:52:51 pm »
Hi Agate,

Sorry I am late in replying. It looks like you got through the treatment o.k. That's great. Congratulations!

Vivian
CPA AN(most likely meningioma) 1.6cm by 1.5cm by 1.9cm diagnosed early March 09. Watch and Wait.

 


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