Cavernous sinus meningiomas

Fa, Cioffi; Fp, Bernini; Punzo, A; Natale, Massimo; Muras, I.

doi:10.1055/s-2008-1053654

Cited by 14 publications

(8 citation statements)

References 2 publications

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“…4 plete resection of a cavernous sinus tumor ranges from 22.9 to 100%. 3,6,10,11,18,29,30,34,37 The mortality rate in modern microsurgical series ranges from 0 to 7%. 10,29,35 Permanent cranial nerve deficits were noted in a significant percentage of patients (8-26%).…”

Section: Discussionmentioning

confidence: 99%

Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas

Lee

Niranjan

McInerney

et al. 2002

Journal of Neurosurgery

368

170

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Section: Discussionmentioning

confidence: 99%

Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas

Lee

Niranjan

McInerney

et al. 2002

Journal of Neurosurgery

368

170

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“…Recent literature suggests that conservative resection followed by radiation therapy leads to better preservation of neural function. [3,8,19,[20][21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Radiosurgery and Stereotactic Radiation Therapy of Skull Base Meningiomas: Proposal of a Grading System

Salles

Frighetto

Grande

et al. 2001

Stereotact Funct Neurosurg

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Objective: The development of a grading system to guide treatment selection, and predict treatment difficulty and outcome of skull base meningiomas infiltrating the cavernous sinus which are managed by stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT), based on an 8-year experience with stereotactic radiation of skull base meningiomas. Methods: T1 gadoliniun-enhanced magnetic resonance imaging (MRI) of 40 patients with skull base meningiomas, with or without prior surgery, who underwent radiosurgery or stereotactic radiation therapy from 1991 to 1998 at the UCLA Medical Center were reviewed, and the result of treatment was related to the tumor grade. Grade was based on tumor infiltration of the cavernous sinus and extension into adjacent structures. Treatment was performed with a linac-based system. The dose prescribed to the periphery of the tumor for SRS patients (n = 34) ranged from 12 to 22 Gy, and the maximum dose delivered to the tumor ranged from 24 to 46 Gy. SRT (n = 6). Treatment was planned using a single isocenter, usually prescribed to the 90% isodose volume, bringing the fractionation scheme to the maximal tolerance of the optic apparatus. The periphery dose ranged from 24 to 46 Gy with a maximum dose of 45 to 51 Gy. Clinical and MRI follow-up was performed every six months for the first 3 years and every year thereafter. Results: Grade I meningiomas were restricted to the cavernous sinus (n = 12). Grade II cavernous sinus meningiomas extended to the clivus and/or the petrous bone, without compression of the brainstem (n = 9). Grade III meningiomas had superior and/or anterior extension with compression of the optic nerve or tract (n = 9). Grade IV tumors compressed the brain stem (n = 8), and Grade V were bilateral lesions (n = 2). Tumor control rates were 90% for Grade I, 86% for Grade II, 86% for Grade III, 42% for Grade IV and no control for tumors Grade V. Complications were not related to tumor grade. Conclusion: This grading system correlated with outcome and difficulty in planning radiosurgery. Failure of treatment was more likely to occur in patients with higher Grade tumors.

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“…In fact, the risk of neurological morbidity and death following the resection of skull base meningiomas is not inconsequential. 1,[7][8][9][10]17,21,[23][24][25]28,42,[49][50][51][52]56 Although parasellar meningiomas are typically histologically benign tumors, they can be intimately involved with critical neural and vascular structures of the skull base making complete resection difficult. Thus, the goals of treatment in some cases have shifted from oncological cure to local tumor control and preservation of neurological function.…”

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confidence: 99%

Gamma Knife surgery for parasellar meningiomas: long-term results including complications, predictive factors, and progression-free survival

Williams¹,

Yen²,

Starke³

et al. 2011

JNS

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Object. Stereotactic radiosurgery serves as an important primary and adjuvant treatment option for patients with many types of intracranial meningiomas. This is particularly true for patients with parasellar meningiomas. In this study, the authors evaluated the outcomes of Gamma Knife surgery (GKS) used to treat parasellar meningiomas.Methods. The study is a retrospective review of the outcomes in 138 patients with meningiomas treated at the University of Virginia from 1989 to 2006; all patients had a minimum follow-up of 24 months. There were 31 men and 107 women whose mean age was 54 years (range 19-85 years). Eighty-four patients had previously undergone resection. The mean pre-GKS tumor volume was 7.5 ml (range 0.2-54.8 ml). Clinical and radiographic evaluations were performed, and factors related to favorable outcomes in each case were assessed.Results. The mean follow-up duration was 84 months (median 75.5 months, range 24-216 months). In 118 patients (86%), the tumor volume was unchanged or had decreased at last follow-up. Kaplan-Meier analysis demonstrated radiographic progression-free survival at 5 and 10 years to be 95.4% and 69%, respectively. Fourteen patients (10%) developed new cranial nerve palsies following GKS. Factors associated with tumor control included younger age, a higher isodose, and smaller tumor volume. A longer follow-up duration was associated with either a decrease or increase in tumor volume. Fourteen patients (10%) experienced new or worsening cranial nerve deficits after treatment. Factors associated with this occurrence were larger pretreatment tumor volume, lower peripheral radiation dose, lower maximum dose, tumor progression, and longer follow-up.Conclusions. Gamma Knife surgery offers an acceptable rate of tumor control for parasellar meningiomas and accomplishes this with a low incidence of neurological deficits. Radiological control after radiosurgery is more likely in those patients with a smaller tumor volume and a higher prescription dose. (DOI: 10.3171/2011.1.JNS091939) keY WorDs • stereotactic radiosurgery • parasellar meningioma • skull base • cavernous sinus 1571Abbreviations used in this paper: GKS = Gamma Knife surgery; PFS = progression-free survival.

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Cavernous sinus meningiomas

Cited by 14 publications

References 2 publications

Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas

Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas

Radiosurgery and Stereotactic Radiation Therapy of Skull Base Meningiomas: Proposal of a Grading System

Gamma Knife surgery for parasellar meningiomas: long-term results including complications, predictive factors, and progression-free survival

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