Browsing by Author "Peker, Selcuk"

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Gamma Knife Radiosurgery for Anterior Clinoid Process Meningiomas: A Series of 61 Consecutive Patients
(ELSEVIER SCIENCE INC, 2020-01-01) Akyoldas, Goktug; Hergunsel, Omer Batu; Yilmaz, Meltem; Sengoz, Meric; Peker, Selcuk
OBJECTIVE: Gamma Knife radiosurgery (GKRS) outcomes for anterior clinoid process (ACP) meningiomas have not been specifically reported within any meningioma series. We present the initial and largest series in the literature that describes the presenting features, radiosurgery parameters, and radiologic and long-term clinical outcomes for 61 patients with ACP meningiomas treated with GKRS. METHODS: Medical records were reviewed for 61 consecutive patients at a single center who underwent GKRS for ACP meningioma between 2008 and 2016. RESULTS: Of 61 patients with ACP meningiomas, 49 (80\%) were treated with GKRS as primary treatment, and 12 (20\%) were treated with GKRS as an adjuvant therapy. Before GKRS, 29 patients presented with visual impairment and 50 patients presented with headache. Median patient age was 54.9 years. Median tumor volume was 3.2 cm(3), and median margin dose was 12.0 Gy. The median radiologic follow-up time after GKRS was 75 months. During follow-up, tumor volume regressed in 37 cases (61\%) and remained unchanged in 24 cases (39\%). None of the patients experienced tumor volume progression. Tumor volume <3 cm(3) was an independent predictor of tumor volume regression after GKRS (univariate analysis, P = 0.047
Gamma Knife Radiosurgery for Arteriovenous Malformations: Clinical Series of 199 Patients
(TURKISH NEUROSURGICAL SOC, 2017-01-01) Arslan, Ipek; Tezcanli, Evrim; Yilmaz, Meltem; Cizmeli, Olcay; Sengoz, Meric; Peker, Selcuk
AIM: Cerebral arteriovenous malformations (AVM) are pathological connections between arteries and veins without capillaries. Stereotactic radiosurgery (RS) is a proven and accepted treatment method for cerebral AVMs. Our objective was to analyze the factors influencing the clinical outcome in patients suffering from AVMs. MATERIAL and METHODS: We retrospectively reviewed 199 patients who were treated with Gamma-Knife RS for intracranial AVMs between 13 October 2005 and 31 October 2010. There were 89 male, 110 female patients with a median age of 32 years (range, 3-74 years). Obliteration was assessed with MRI angiography and DSA imaging. RESULTS: Complete obliteration rate after RS was 71 \% (141 out of 199), including second RS treatments. In terms of obliteration rates, there was no significant difference between patients younger and older than 21 years old (p=0.669). After RS, 3 patients died due to intracranial hemorrhage and 1 died of heart disease. Death from AVM was determined as 1.5 \%. Intracranial hemorrhage was observed in 7 (3.5 \%) patients post-RS. CONCLUSION: Obliteration was found to be associated with Spetzler-Martin Grade, Pollock-Flickinger Grade, AVM volume, RS dose, bleeding history before RS and no previous embolization before RS. Gamma knife RS is an effective treatment method for the treatment of AVMs both for pediatric and adult patients. It provides high obliteration and low mortality rates.
Gamma Knife Radiosurgery for Hemorrhagic Brainstem Cavernomas
(TURKISH NEUROSURGICAL SOC, 2019-01-01) Ucuncu Kefeli, Aysegul; Sengoz, Meric; Peker, Selcuk
AIM: To assess treatment results of gamma knife radiosurgery (GKRS) for hemorrhagic brainstem cavernous malformations (BSCMs). MATERIAL and METHODS: A retrospective review of patients with hemorrhagic BSCMs, who were treated at the Acibadem Kozyatagi Hospital GKRS unit from May 2007 to October 2015 was performed. RESULTS: In total, 82 patients were identified. All patients had experienced at least one hemorrhagic event (range 1-3), and all of them presented with radiological evidence of hemorrhage. The median target volume was 0.3 ml, and the median marginal radiation dose was 12 Gy. The mean durations before and after surgery were 25.5 (range 1-204) months, and 50.3 (range 13-113) months, respectively. Pre-treatment hemorrhage rates were calculated from the date of first hemorrhage to the date of radiosurgery. There were 97 bleeds over 174.4 patient-years during the observation period, with an annual hemorrhage rate of 55.7\%. If the first bleed is excluded, the annual hemorrhage rate was 8.6\%. Only three patients demonstrated re-bleeding, which occurred at 3, 12 and 79 months after radiosurgery. Over a total follow up time of 344 patient-years the annual re-bleeding rate was therefore 0.87\%, indicating that the risk of BSCM hemorrhage was significantly decreased by radiosurgery. CONCLUSION: GKRS was a safe and effective treatment for symptomatic low volume BSCMs when a low marginal dose is used. A randomized controlled trial is needed that compares GKRS to observation if we want to establish the true efficacy of this treatment.
GAMMA KNIFE RADIOSURGERY FOR RECURRENT HIGH GRADE GLIOMAS
(OXFORD UNIV PRESS INC, 2014-01-01) Peker, Selcuk; Kabalay, Ipek Arslan; Tezcanli, Evrim; Yilmaz, Meltem; Sengoz, Meric
Gamma Knife Radiosurgery for Tumors of the Endolymphatic Sac
(TURKISH NEUROSURGICAL SOC, 2017-01-01) Ucuncu Kefeli, Aysegul; Yilmaz, Meltem; Sengoz, Meric; Peker, Selcuk
Tumors of the endolymphatic sac are locally invasive temporal bone neoplasms. Radical surgical excision is the treatment of choice