Gamma Knife Radiosurgery for Cerebellopontine Angle Meningiomas

Ding, Dale; Starke, Robert M.; Kano, Hideyuki; Nakaji, Peter; Barnett, Gene H.; Mathieu, David; Chiang, Veronica; Omay, Sacit Bulent; Hess, Judith; McBride, Heyoung; Honea, Norissa; Lee, John Y.K.; Rahmathulla, Gazanfar; Evanoff, Wendi; Alonso‐Basanta, Michelle; Lunsford, L. Dade; Sheehan, Jason P.

doi:10.1227/neu.0000000000000480

Cited by 41 publications

(30 citation statements)

References 43 publications

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“…18,69,70,75 However, it is unclear what role SRS plays in the treatment of AMs. A review of modern literature on SRS suggests that this modality can be effective for biopsy-proven AMs (Table 5).…”

Section: Radiosurgery As An Adjuvant and Salvage Treatmentmentioning

confidence: 99%

“…A review of modern literature on SRS suggests that this modality can be effective for biopsy-proven AMs (Table 5). 4,12,18,[25][26][27]50,61 In particular, adjuvant SRS following STR resulted in equivalent rates of long-term tumor control as adjuvant EBRT (EBM Level 3, Grade 2C recommendation), 26,77 although SRS tended to be used for smaller residual tumors in a smaller resection bed. 77 SRS is also used as a salvage measure for AMs for which surgery and EBRT have failed.…”

Section: Radiosurgery As An Adjuvant and Salvage Treatmentmentioning

confidence: 99%

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An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Sun¹,

Hawasli²,

Huang

et al. 2015

FOC

113

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The management of WHO Grade II “atypical” meningiomas (AMs) and Grade III “malignant” meningiomas (MMs) remains controversial and under-investigated in prospective studies. The roles of surgery, radiation therapy, radiosurgery, and chemotherapy have been incompletely delineated. This has left physicians to decipher how they should treat patients on a case-by-case basis. In this study, the authors review the English-language literature on the management and clinical outcomes associated with AMs and MMs diagnosed using the WHO 2000/2007 grading criteria. Twenty-two studies for AMs and 7 studies for MMs were examined in detail. The authors examined clinical decision points using the literature and concepts from evidence-based medicine. Acknowledging the retrospective nature of the studies concerning AM and MM, the authors did find evidence for the following clinical strategies: 1) maximal safe resection of AM and MM; 2) active surveillance after gross-total resection of AM; 3) adjuvant radiation therapy after subtotal resection of AM, especially in the absence of putative radioresistant features; and 4) adjuvant radiation therapy after resection of MM.

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Section: Radiosurgery As An Adjuvant and Salvage Treatmentmentioning

confidence: 99%

Section: Radiosurgery As An Adjuvant and Salvage Treatmentmentioning

confidence: 99%

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Sun¹,

Hawasli²,

Huang

et al. 2015

FOC

113

View full text Add to dashboard Cite

show abstract

“…Progression free survival was 98 to 99% at 1 year, 96 to 98%% at 3 years, 93 to 95% at 5 years, and 77 to 87% at 10 years. [53][54][55] Cranial nerve function was improved in 31 to 34%, unchanged in 49 to 58%, and worsened in 11 to 17%. 54,55 The least likely symptoms to improve were hearing loss and tinnitus, with improvement in 31% of patients at 3-year follow-up.…”

Section: Treatmentmentioning

confidence: 94%

Tinnitus Management in Lateral Skull Base Lesions

San-Juan

Basura

2018

J Neurol Surg B

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Tinnitus, the phantom perception of sound in the absence of a physical sound source, is a complex problem with multiple etiologies. While most commonly presenting in a subjective fashion caused by measurable hearing loss, other etiologies including lateral skull base tumors that encroach on middle and inner ear structures can lead to phantom sound perception as well. In addition to discussing the basic background of tinnitus, here we also review current theories of etiology that include central auditory and nonauditory neural mechanisms and potential treatments that range from sound therapy to medications to cognitive and behavioral therapies and cranial nerve and brain stimulation. One main purpose of this article is to relate tinnitus causes to skull base tumors, surgical removal, and resultant sequelae, including damage to cranial nerves resulting in audiovestibular dysfunction. We also discuss the utility of microvascular decompression for both tumor and nontumor-associated tinnitus and the current literature regarding hearing preservation rates and tinnitus perception, where documented, with the three common treatment modalities employed for most lateral skull base tumors that includes watchful waiting with serial imaging, stereotactic radiosurgery and primary surgical resection using hearing preservation and hearing ablative approaches. The management of skull base tumors is a complex process that depending upon the approach and sequelae, may lead to manageable or worsening phantom sound perception that must be considered when discussing the multiple treatment options with patients.

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“…[7,8] Furthermore, GKRS is an effective therapy (a non-invasive alternative to surgery) for primary brainstem tumors. [9] The pons is the common-est location of brainstem metastases (primarily from lung cancer), with a frequency ranging from 51.85% to 79.25% (see Table 1). [4,[6][7][8][10][11][12][13][14] The purpose of this review is to explore the role of radiosurgery in the management of pontine metastases.…”

Section: Introductionmentioning

confidence: 99%

The role of stereotactic radiosurgery in the management of secondary pontine tumors

Mavridis

2015

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Brainstem metastasis is an uncommon complication of systemic cancer and is generally considered to have a highly unfavorable prognosis. Regarding its management, stereotactic radiosurgery (SRS) is nowadays used as a feasible treatment option and is expected to achieve a radical cure. The pons is the commonest location of brainstem metastases (primarily from lung cancer), with a frequency ranging from 51.9% to 79.3%. The purpose of this review is to explore the role of radiosurgery in the management of pontine metastases. Methodologically, a combined PubMed search was mainly applied for the terms "radiosurgery" and "pontine metastases". Beside other treatment efforts, SRS has a major role in the management of patients with secondary pontine tumors, as a safe and effective treatment option that prolongs survival with low complications rate. The mean dose used for this purpose is approximately 17 Gy and the achieved median survival of the treated patients is nearly 9 months. Although larger lesions as well as melanoma and renal cancer usually have a worse prognosis, the patient's clinical status seems to be more important in determining survival. SRS is currently a principal treatment option for patients suffering from pontine metastases.

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Gamma Knife Radiosurgery for Cerebellopontine Angle Meningiomas

Abstract: GKRS is an effective therapy for CPA meningiomas. Depending on the patient and tumor characteristics, radiosurgery can be an adjuvant treatment to initial surgical resection or a standalone procedure that obviates the need for resection in most patients.

Cited by 41 publications

References 43 publications

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Tinnitus Management in Lateral Skull Base Lesions

The role of stereotactic radiosurgery in the management of secondary pontine tumors

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