Gamma knife surgery for atypical meningiomas

Huffmann, Beate C.; Reinacher, Peter C.; Gilsbach, Joachim M.

doi:10.3171/jns.2005.102.s_supplement.0283

Cited by 45 publications

(20 citation statements)

References 19 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,6 Recently, radiosurgery has been shown to be a safe and effective treatment for the growth of atypical and malignant meningiomas, especially for small lesions. 8,9,20 Harris and colleagues 8 reported the efficacy of early boost radiosurgery following adjuvant radiotherapy for malignant meningioma. The optimal dose of GKS required to control tumor progression depends on several factors, including tumor size, tumor location, dosimetry of prior radiation, and safe radiation dose to the surrounding tissue.…”

Section: Discussionmentioning

confidence: 99%

Boron neutron capture therapy for recurrent malignant meningioma

Tamura

Miyatake

Nonoguchi

et al. 2006

JNS

View full text Add to dashboard Cite

Malignant meningioma is a rare brain tumor with a high risk of recurrence. If this tumor recurs after complete resection and adjuvant radiotherapy, there is no optimal treatment to control it. The authors report the first case of recurrent malignant meningioma treated using boron neutron capture therapy (BNCT). This 25-year-old pregnant woman presented with a large frontal tumor. After her baby was born, she underwent gross-total resection of the tumor. A second resection and three Gamma Knife surgeries could not control progression of the enhancing mass; therefore, the authors applied BNCT based on their experience with it in the treatment of malignant gliomas. The minimum tumor dose and maximum brain tissue dose were estimated as 39.7 Gy-Eq and less than 9.0 Gy-Eq, respectively. Before BNCT the patient was mobile by wheelchair only, whereas 1 week after therapy she was able to walk. Twenty-two weeks later she underwent a second BNCT for tumor regrowth on the contralateral side, and the lesion was subsequently reduced. The tumor volume was markedly decreased from 65.6 cm3 at the time of the first BNCT to 31.8 cm3 at 26 weeks thereafter. The treatment of recurrent malignant meningioma is difficult and has been discouraging thus far. Data in the present case indicate that BNCT may be a promising treatment option for this challenging tumor.

show abstract

Section: Discussionmentioning

confidence: 99%

Boron neutron capture therapy for recurrent malignant meningioma

Tamura

Miyatake

Nonoguchi

et al. 2006

JNS

View full text Add to dashboard Cite

show abstract

“…Although we treated the tumors with relatively small vol ume using higher margin doses, the LC rates were worse than those in the past reports. 3,5,6,18 The favorable out comes in the past literature might be partly attributable to the variability of the treated tumors because of vagueness in histological definition of atypical meningioma before the year of 2000. 5,6,10 In addition, in recently published cases, 3,18 a larger portion of the patients underwent prior radiotherapy, which may also be one of the factors leading to the better LC rates in previous reports than in our study.…”

Section: Discussionmentioning

confidence: 99%

“…In previous reports, 3,5,6,18 the 5year LC rates after GKS for atypical meningioma were highly variable, ranging from 44% to 83% (Table 3). In contrast, the LC rates in the present study were 74% at 1 year, 39% at 2 years, and 16% at 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…The followup images were compared with the MRI or CT image acquired during the treatmentplanning phase. The type of recurrence pattern was categorized ac cording to the definition in previous reports 3,6,18 as the fol lowing: local recurrence (tumor progression extended > 2 cm out of the prescription dose line); marginal recurrence (tumor newly grew out of the prescribed line but < 2 cm from its margin); and distant recurrence (noncontiguous region from the site where the tumor initially existed). Typical patterns of local recurrence, marginal recurrence, and distant recurrence are illustrated in Fig.…”

Section: Follow-up and Evaluation Statistical Analysismentioning

confidence: 99%

“…There are only a few published studies reporting their outcomes of SRS in which the results of these 2 histological types were analyzed together, with tumor control rates at 5 years ranging from 25% to 83%. 3,5,6,18 Thus, at present, the role of SRS in the treatment strategy of atypical meningiomas alone remains unclear.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Role of Gamma Knife surgery for intracranial atypical (WHO Grade II) meningiomas

Hanakita¹,

Koga²,

Igaki

et al. 2013

JNS

View full text Add to dashboard Cite

Object Atypical meningioma often recurs even after resection. As a salvage modality, radiotherapy or stereotactic radiosurgery (SRS) is attempted for this aggressive tumor. This retrospective study was performed to evaluate the efficacy of SRS that involved Gamma Knife surgery (GKS) for atypical meningioma. Methods The authors reviewed records from 22 patients with histologically proven atypical meningioma who underwent GKS for 28 lesions at the authors' institute. The median patient age was 70 years (range 24–91 years), and the median tumor volume for each procedure was 6.0 cm3 (range 1.6–38.7 cm3). The margin dose ranged from 14 to 20 Gy (median 18 Gy). Follow-up periods ranged from 3 months to 98 months (median 23.5 months). Results In total, 39 GKS procedures were performed for 28 lesions. The local control rates at 1, 2, and 5 years were 74%, 39%, and 16%, respectively. Volume less than 6 cm3 (p = 0.01), a margin dose higher than 18 Gy (p = 0.02), and a Karnofsky Performance Scale (KPS) score of 90 or more (p = 0.02) were factors associated with a longer duration of tumor control in the univariate analysis. Conclusions Atypical meningioma could be more successfully controlled when a higher margin dose was used to treat patients with a good performance (KPS score of ≥ 90) status and smaller tumor volumes. It would be desired if patients are treated with a relatively higher margin dose, ideally as high as the dose applied for malignant tumor. A boost SRS after fractionated radiotherapy may be effective to achieve better local control.

show abstract