Radiation Oncology/Epilepsy

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  • UC San Francisco -- SRS 20 Gy vs SRS 24 Gy
    • Randomized. 30 patients, intractable medial temporal lobe epilepsy. Arm 1) SRS 20 Gy vs Arm 2) SRS 24 Gy. Target at the amygdala, 2 cm of the anterior hippocampus and parahipocampal gyrus, 50% prescription isodose. Used post-treatment MRI, and seizure remission (complete seizure control between 24 and 36 months after therapy)
    • 2010 PMID 20065252 -- "Predictors of efficacy after stereotactic radiosurgery for medial temporal lobe epilepsy." (Chang EF, Neurology. 2010 Jan 12;74(2):165-72.)
      • Outcome: seizure-free 20 Gy 59% vs 24 Gy 77% (NS). MRI response variable, despite standardized targeting. Degree of early MRI alterations predicted long-term seizure remission
      • Conclusion: Temporal lobe SRS resulted in significant seizure reduction, in a delayed fashion