gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Gamma Knife radiosurgery of benign petroclival and cavernous sinus meningiomas: results of a single institution retrospective analysis based on a prospective data base of more than 10-years

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  • R. Wolff - Zentrum für Radiochirurgie und Präzisionsbestrahlung, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main; Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • R. Heyd - Zentrum für Radiochirurgie und Präzisionsbestrahlung, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main; Klinik für Strahlentherapie und Onkologie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • C. Rödel - Zentrum für Radiochirurgie und Präzisionsbestrahlung, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.02.04

doi: 10.3205/12dgnc032, urn:nbn:de:0183-12dgnc0320

Published: June 4, 2012

© 2012 Wolff et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Single fraction stereotactic Gamma Knife radiosurgery (GKRS) is an established treatment option in the management of skull base meningiomas. This study aims at local control, clinical symptomatology, as well as early or late toxicity related to GKRS according to Common Terminology Criteria for Adverse Events (CTCAE).

Methods: From 2001–2011 a total of 81 consecutive patients (56 females / 21 males) with a mean age of 57.9, (range: 34–87 yrs.) underwent GKRS. In 28 patients (36.4%) GKRS was applied to sterilize residual tissue after incomplete microsurgical resection of functionally inoperable benign meningioma, whereas the remaining 49 patients (63.6%) received primary GKRS after diagnosis of the lesions by magnetic resonance imaging (MRI) studies. The tumor volumes ranged from 0.7 to 14.4 cm3 (mean: 5.45 cm3). The marginal doses were in the range of 12 to 16 Gy applied to the 43-64% isodose line (median 50).

Results: The tolerance of the treatment was excellent in all of the patients and assessed by the CTCAE scale no relevant early toxicity was noted. After a median follow-up period of 58 months (mean: 59.6 months, range: 3–122 months) 77 of the 81 patients (93.5%) were clinically stable, new neurological deficits occurred in 5 patients (6.5%). Periodic MRI control examinations revealed that only four patients (5.2%) had a progression in size, a local tumor control rate of 94.8 % during the follow-up period after radiosurgery is demonstrated. One patient received a second GKRS treatment as salvage treatment option resulting in local control. Four patients developed an increase in pre-existing cranial nerve deficits, analysis of the late toxicity by the CTCAE scale revealed one grade III toxicity.

Conclusions: Gamma Knife radiosurgery is an attractive option for patients with skull base meningiomas. It can be used as both primary treatment based on imaging diagnosis alone or as an adjunct treatment after craniotomy. It provides long-term tumor control with minimal adverse sequelae.