Radiosurgery and stereotactic radiotherapy for intracranial meningiomas

Torres, R.C.; Frighetto, Leonardo; Salles, Antonio A. F. De; Goss, Brian C.; Medin, Paul M.; Solberg, T.D.; Ford, Judith M.; Selch, Michael T.

doi:10.3171/foc.2003.14.5.6

Cited by 71 publications

(47 citation statements)

References 42 publications

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“…13 Clinical studies comparing surgery alone with surgery and adjuvant radiotherapy have demonstrated that adjuvant radiotherapy of benign meningiomas improves both tumour control and survival with a higher probability of recurrence-free survival. 14 There is also a role for radiotherapy in the primary treatment of meningioma where surgery is not possible (either due to tumour factors, such as site, or to patient factors), 15,16 or in the treatment of recurrent meningioma following previous gross total resection. 16 The development of stereotactic irradiation has revolutionised the treatment of skull base meningiomas.…”

Section: Discussionmentioning

confidence: 99%

Role of hypofractionated stereotactic radiotherapy in treatment of skull base meningiomas

Gorman

Ruben

Myers

et al. 2008

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

Role of hypofractionated stereotactic radiotherapy in treatment of skull base meningiomas

Gorman

Ruben

Myers

et al. 2008

Journal of Clinical Neuroscience

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“…34 Recent advances in the use of both photon and proton radiation techniques, intensity-modulated radiation therapy (IMRT), or image-guided radiation therapy (IGRT) have demonstrated no substantive improvement in tumor con- trol or any reduction in complications in the management of meningiomas. 29,33,34,57,59,60 …”

Section: Resection and Radiation Therapymentioning

confidence: 99%

Gamma Knife radiosurgery for sellar and parasellar meningiomas: a multicenter study

Sheehan

Starke

Kano

et al. 2014

JNS

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Object Parasellar and sellar meningiomas are challenging tumors owing in part to their proximity to important neurovascular and endocrine structures. Complete resection can be associated with significant morbidity, and incomplete resections are common. In this study, the authors evaluated the outcomes of parasellar and sellar meningiomas managed with Gamma Knife radiosurgery (GKRS) both as an adjunct to microsurgical removal or conventional radiation therapy and as a primary treatment modality. Methods A multicenter study of patients with benign sellar and parasellar meningiomas was conducted through the North American Gamma Knife Consortium. For the period spanning 1988 to 2011 at 10 centers, the authors identified all patients with sellar and/or parasellar meningiomas treated with GKRS. Patients were also required to have a minimum of 6 months of imaging and clinical follow-up after GKRS. Factors predictive of new neurological deficits following GKRS were assessed via univariate and multivariate analyses. Kaplan-Meier analysis and Cox multivariate regression analysis were used to assess factors predictive of tumor progression. Results The authors identified 763 patients with sellar and/or parasellar meningiomas treated with GKRS. Patients were assessed clinically and with neuroimaging at routine intervals following GKRS. There were 567 females (74.3%) and 196 males (25.7%) with a median age of 56 years (range 8–90 years). Three hundred fifty-five patients (50.7%) had undergone at least one resection before GKRS, and 3.8% had undergone prior radiation therapy. The median follow-up after GKRS was 66.7 months (range 6–216 months). At the last follow-up, tumor volumes remained stable or decreased in 90.2% of patients. Actuarial progression-free survival rates at 3, 5, 8, and 10 years were 98%, 95%, 88%, and 82%, respectively. More than one prior surgery, prior radiation therapy, or a tumor margin dose < 13 Gy significantly increased the likelihood of tumor progression after GKRS. At the last clinical follow-up, 86.2% of patients demonstrated no change or improvement in their neurological condition, whereas 13.8% of patients experienced symptom progression. New or worsening cranial nerve deficits were seen in 9.6% of patients, with cranial nerve (CN) V being the most adversely affected nerve. Functional improvements in CNs, especially in CNs V and VI, were observed in 34% of patients with preexisting deficits. New or worsened endocrinopathies were demonstrated in 1.6% of patients; hypothyroidism was the most frequent deficiency. Unfavorable outcome with tumor growth and accompanying neurological decline was statistically more likely in patients with larger tumor volumes (p = 0.022) and more than 1 prior surgery (p = 0.021). Conclusions Gamma Knife radiosurgery provides a high rate of tumor control for patients with parasellar or sellar meningiomas, and tumor control is accompanied by neurological preservation or improvement in most patients.

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“…Postoperative external beam radiation therapy improves long-term local control of subtotally resected or recurrent meningiomas [1,7,17,20,34].…”

Section: Discussionmentioning

confidence: 99%

μMLC-LINAC radiosurgery for intracranial meningiomas of complex shape

et al. 2012

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Radiosurgery and stereotactic radiotherapy for intracranial meningiomas

Cited by 71 publications

References 42 publications

Role of hypofractionated stereotactic radiotherapy in treatment of skull base meningiomas

Role of hypofractionated stereotactic radiotherapy in treatment of skull base meningiomas

Gamma Knife radiosurgery for sellar and parasellar meningiomas: a multicenter study

μMLC-LINAC radiosurgery for intracranial meningiomas of complex shape

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