Efficacy and Safety of Gamma Knife Radiosurgery for Meningiomas in Patients with Neurofibromatosis Type 2: A Long-Term Follow-Up Single-Center Study

Gao, Faliang; Li, Min; Wang, Zheng; Shi, Ling-Fei; Lin, Li; Zhou, Jia

doi:10.1016/j.wneu.2019.01.211

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…However, the role of radiosurgery on sporadic skull base meningiomas has been widely explored. 13,[15][16][17][18]24, The cohort of patients described here has a median age at the time of GKRS of 38 years (10-79 years), which is in line with what has been described for NF-2 associated meningiomas in general 64,65 and the fact that treatment is needed at a younger age when compared with sporadic meningioma populations. Our cohort of patients demonstrated a 2-year PFS of 98.1% and 5-, 10-, and 20-year rates of 90.0%.…”

Section: Gamma Knife Radiosurgery For Neurofibromatosis Type-2 Associ...supporting

confidence: 85%

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Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Ruiz‐Garcia

Trifiletti

Mohammed

et al. 2021

J Neurol Surg B Skull Base

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Objective Meningiomas are the second most common tumors in neurofibromatosis type 2 (NF-2). Microsurgery is challenging in NF-2 patients presenting with skull base meningiomas due to the intrinsic risks and need for multiple interventions over time. We analyzed treatment outcomes and complications after primary Gamma Knife radiosurgery (GKRS) to delineate its role in the management of these tumors. Methods An international multicenter retrospective study approved by the International Radiosurgery Research Foundation was performed. NF-2 patients with at least one growing and/or symptomatic skull base meningioma and 6-month follow-up after primary GKRS were included. Clinical and radiosurgical parameters were recorded for analysis. Results In total, 22 NF-2 patients with 54 skull base meningiomas receiving GKRS as primary treatment met inclusion criteria. Median age at GKRS was 38 years (10–79 years). Most lesions were located in the posterior fossa (55.6%). Actuarial progression free survival (PFS) rates were 98.1% at 2 years and 90.0% at 5 and 10 years. The median follow-up time after initial GKRS was 5.0 years (0.6–25.5 years). Tumor volume at GKRS was a predictor of tumor control. Lesions >5.5 cc presented higher chances to progress after radiosurgery (p = 0.043). Three patients (13.64%) developed adverse radiation effects. No malignant transformation or death due to meningioma or radiosurgery was reported. Conclusions GKRS is effective and safe in the management of skull base meningiomas in NF-2 patients. Tumor volume deserve greater relevance during clinical decision-making regarding the most appropriate time to treat. GKRS offers a minimally invasive approach of particular interest in this specific group of patients.

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Section: Gamma Knife Radiosurgery For Neurofibromatosis Type-2 Associ...supporting

confidence: 85%

“…Similarly, none of the patients from three series of GKRS on NF-2 meningiomas, with 286 treated meningiomas in total, developed malignant transformation. 64 65 67 No death associated with a meningioma was reported in our cohort.…”

Section: Discussionmentioning

confidence: 69%

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Ruiz‐Garcia

Trifiletti

Mohammed

et al. 2021

J Neurol Surg B Skull Base

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“…The overall meningioma burden or distant failure rate was reported in some studies ranging between 27% and 51%. 87 , 89 , 90 Additionally, the risk of distant failure in one study was related to the number of SRS treatments. 90 Overall mortality ranged from 17 to 33%.…”

Section: Clinical Management and Quality Of Life Outcomesmentioning

confidence: 98%

“…These have included 12 to 39 patients (number of meningioma 99–204) with median follow-up periods ranging between 4 and 9 years. 87–90 The 5-year local control rates were >90%. No cases of malignant transformation were reported.…”

Section: Clinical Management and Quality Of Life Outcomesmentioning

confidence: 99%

“…In patients who died within these series, data on causes of death or autopsy reports were not always available. Yet despite some cases (3%–33% of overall study populations) describing the cause of death as “multiple de novo” and “progressive” meningioma, 87 , 90 the risk of transformation into a higher-grade meningioma with aggressive behavior is not acknowledged. Moreover, in a large natural history study of 74 patients followed-up for a mean of 9 years, the risk of de novo meningioma formation was 16%, 19 lower than the reported local failure rates in these reports.…”

Section: Clinical Management and Quality Of Life Outcomesmentioning

confidence: 99%

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The clinical, genetic, and immune landscape of meningioma in patients with NF2-schwannomatosis

Gregory

Islim

Hannan

et al. 2023

Neuro-Oncology Advances

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NF2-schwannomatosis is the most common genetic predisposition syndrome associated with meningioma. Meningioma in NF2-schwannomatosis is a major source of morbidity and mortality. This is due to accumulative tumor burden in patients with synchronous schwannomas and ependymomas, sometimes including complex collision tumors. Balancing the impact of multiple interventions against the natural history of various index tumors, and the ongoing risk of de novo tumors over an individual’s lifetime makes decision-making complex. The management of any given individual meningioma is often different from a comparable sporadic tumor. There is typically a greater emphasis on conservative management and tolerating growth until a risk boundary is reached, whereby symptomatic deterioration or higher risk from anticipated future treatment is threatened. Management by high-volume multidisciplinary teams improves quality of life and life expectancy. Surgery remains the mainstay treatment for symptomatic and rapidly enlarging meningioma. Radiotherapy has an important role but carries a higher risk compared to its use in sporadic disease. Whilst bevacizumab is effective in NF2-associated schwannoma and cystic ependymoma, it has no value in the management of meningioma. In this review, we describe the natural history of the disease, underlying genetic, molecular, and immune microenvironment changes, current management paradigms, and potential therapeutic targets.

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Stereotactic radiosurgery for vestibular schwannomas in neurofibromatosis type 2 patients: a systematic review and meta-analysis

Tosi

Maayan

et al. 2022

J Neurooncol

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Efficacy and Safety of Gamma Knife Radiosurgery for Meningiomas in Patients with Neurofibromatosis Type 2: A Long-Term Follow-Up Single-Center Study

Cited by 9 publications

References 17 publications

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

The clinical, genetic, and immune landscape of meningioma in patients with NF2-schwannomatosis

Stereotactic radiosurgery for vestibular schwannomas in neurofibromatosis type 2 patients: a systematic review and meta-analysis

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