Long-term Outcome and Growth Rate of Subtotally Resected Petroclival Meningiomas: Experience with 38 Cases

Jung, Hee-Won; Yoo, Heon; Paek, Sun Ha; Choi, Kyoon

doi:10.1097/00006123-200003000-00008

Cited by 174 publications

(104 citation statements)

References 26 publications

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“…17 The median postoperative time to tumor enlargement on MR imaging among 38 patients with subtotally resected residual petroclival meningiomas was 66 months (87.5 months in our report), and the 5-year PFS rate (indicated by MR imaging criteria) was 60% (75% in our study). 12 Therapeutic costs for Sandostatin LAR are around US $2000/month for each injection. Compared with stereotactic radiosurgery (around US $6500 for a singlefraction treatment or US $3500 + US $1000 for every 2 additional fractions in hypofractionated therapy), the SST therapy is more costly after 4-6 months of treatment (according to the table of charges for physicians in Germany).…”

Section: Discussionmentioning

confidence: 99%

Treatment of unresectable skull base meningiomas with somatostatin analogs

Schulz¹,

Mathieu²,

Kunz³

et al. 2011

FOC

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Object The standard surgical treatment for meningiomas is total resection, but the complete removal of skull base meningiomas can be difficult for several reasons. Thus, the management of certain meningiomas of the skull base—for example, those involving basal vessels and cranial nerves—remains a challenge. In recent reports it has been suggested that somatostatin (SST) administration can cause growth inhibition of unresectable and recurrent meningiomas. The application of SST and its analogs is not routinely integrated into standard treatment strategies for meningiomas, and clinical studies proving growth-inhibiting effects do not exist. The authors report on their experience using octreotide in patients with recurrent or unresectable meningiomas of the skull base. Methods Between January 1996 and December 2010, 13 patients harboring a progressive residual meningioma (as indicated by MR imaging criteria) following operative therapy were treated with a monthly injection of the SST analog octreotide (Sandostatin LAR [long-acting repeatable] 30 mg, Novartis). Eight of 13 patients had a meningioma of the skull base and were analyzed in the present study. Postoperative tumor enlargement was documented in all patients on MR images obtained before the initiation of SST therapy. All tumors were benign. No patient received radiation or chemotherapy before treatment with SST. The growth of residual tumor was monitored by MR imaging every 12 months. Results Three of the 8 patients had undergone surgical treatment once; 3, 2 times; and 2, 3 times. The mean time after the last meningioma operation (before starting SST treatment) and tumor enlargement as indicated by MR imaging criteria was 24 months. A total of 643 monthly cycles of Sandostatin LAR were administered. Five of the 8 patients were on SST continuously and stabilized disease was documented on MR images obtained in these patients during treatment (median 115 months, range 48–180 months). Three of the 8 patients interrupted treatment: after 60 months in 1 case because of tumor progression, after 36 months in 1 case because of side effects, and after 36 months in 1 case because the health insurance company denied cost absorption. Conclusions Although no case of tumor regression was detected on MR imaging, the study results indicated that SST analogs can arrest the progression of unresectable or recurrent benign meningiomas of the skull base in some patients. It remains to be determined whether a controlled prospective clinical trial would be useful.

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Section: Discussionmentioning

confidence: 99%

Treatment of unresectable skull base meningiomas with somatostatin analogs

Schulz¹,

Mathieu²,

Kunz³

et al. 2011

FOC

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“…The postoperative mortality rate ranges from 0% to 9% (median 3.6%). 1-12 38 The variation of total recurrence rates among the surgical series (from 0% to 17%, median 6.7%) is seemingly caused by the range of the follow up periods. [1][2][3][4][5][6][7][8][9][10][11][12] Furthermore, the recurrence/progression rates increase with the duration of follow up, and also seem to be influenced by tumour site and specific histopathological factors.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Kreil¹,

Eustacchio²,

Weigl³

et al. 2007

Skull Base

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“…Simpson et al [10] proposed a grading system based on extent of surgical resection with 5-year local recurrence rates of 9%, 19%, and 29% after Simpson grades 1-3 excision respectively for benign meningiomas. Meningiomas were perceived to be relatively 'radio-resistant' and the anticipated morbidity with conventional RT prevented its use for inoperable or sub-totally resected meningiomas [11,12]. However, with the understanding that meningiomas typically remain stable or regress slowly following RT, several investigators have now reported consistent benefit in outcomes with radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Helical Tomotherapy Based Image-Guided Intensity-Modulated Radiation Therapy for Complex, Irregular, Residual, Recurrent, Progressive Benign/ Low-Grade Meningiomas

Gupta¹,

Wadasadawala²,

Phurailatpam³

2012

J Nucl Med Radiat Ther

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Long-term Outcome and Growth Rate of Subtotally Resected Petroclival Meningiomas: Experience with 38 Cases

Abstract: Subtotal resection with or without radiation or radiosurgery should be considered as a suitable treatment option for patients with petroclival meningiomas, especially the elderly, because the growth rate of residual tumors is low.

Cited by 174 publications

References 26 publications

Treatment of unresectable skull base meningiomas with somatostatin analogs

Treatment of unresectable skull base meningiomas with somatostatin analogs

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Helical Tomotherapy Based Image-Guided Intensity-Modulated Radiation Therapy for Complex, Irregular, Residual, Recurrent, Progressive Benign/ Low-Grade Meningiomas

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