Preservation of cranial nerve function following Gamma Knife radiosurgery for benign skull base meningiomas: experience in 121 patients with follow-up of 5 to 9.8 years.

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  • Additional Information
    • Source:
      Publisher: Springer-Verlag Country of Publication: Austria NLM ID: 100962752 Publication Model: Print Cited Medium: Print ISSN: 0065-1419 (Print) Linking ISSN: 00651419 NLM ISO Abbreviation: Acta Neurochir Suppl Subsets: MEDLINE
    • Publication Information:
      Original Publication: Wien ; New York : Springer-Verlag, c1994-
    • Subject Terms:
      Neurologic Examination* ; Radiosurgery*; Cranial Nerve Diseases/*physiopathology ; Cranial Nerves/*physiopathology ; Meningeal Neoplasms/*surgery ; Meningioma/*surgery ; Postoperative Complications/*physiopathology ; Skull Base Neoplasms/*surgery; Adolescent ; Adult ; Aged ; Child ; Combined Modality Therapy ; Cranial Nerve Diseases/diagnosis ; Cranial Nerves/pathology ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms/diagnosis ; Meningioma/diagnosis ; Microsurgery ; Middle Aged ; Outcome and Process Assessment, Health Care ; Postoperative Complications/diagnosis ; Skull Base Neoplasms/diagnosis
    • Abstract:
      Introduction: Microsurgical excision with preservation of juxtaposed neurovascular structures is considered the treatment of choice for skull base meningiomas, but there exists a great controversy regarding surgical resectability, potential risk for subsequent postoperative Cranial Nerve Deficit (CND) and the role of adjuvant or adjunctive treatment options. In this study we evaluated the effect of Gamma Knife Radiosurgery (GKRS) in 121 patients with benign basal meningiomas after a follow-up of 5 to 9.8 years.
      Methods: Sixty patients had undergone open resections prior to radiosurgical treatment and 61 patients were treated by GKRS alone. Tumour volumes of 0.5 to 89.9 ccm (median 6.8 ccm) received a median marginal dose of 13 Gy (range 7-25 Gy) at the covering 25% to 80% isodose volume curves (median 45%).
      Results: Neuroradiological controls demonstrated decreased tumour size in 73 patients (60.3%), stable meningioma volume in 47 cases (38.9%) and tumour enlargement in one patient (0.8%). Clinically, 54 patients (44.6%) improved and 61 cases (50.4%) remained unchanged. Four patients (3.3%) showed temporary and two patients (1.7%) permanent neurological deterioration (unrelated to tumour or treatment in one patient). Two patients (1.7%) developed radiation induced new or aggravated pre-existent CND (1 transient, 1 permanent) and two patients (1.7%) required further surgical resection.
      Conclusion: In our long-term experience, GKRS proved to be an attractive additional and save alternative primary treatment option in selected patients with basal meningiomas. The tumour control rate of 98.3% associated with excellent clinical outcome and low incidence for treatment related CND (1.7%) compares favourably with the reported microsurgical series.
    • Publication Date:
      Date Created: 20021016 Date Completed: 20030423 Latest Revision: 20191210
    • Publication Date:
      20221213
    • Accession Number:
      10.1007/978-3-7091-6117-3_8
    • Accession Number:
      12379007