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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Gamma knife radiosurgery for benign meningiomas: The results of 661 cases

Meeting Abstract

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  • Hakan Emmez - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Sükrü Aykol - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Erkut Baha Bulduk - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Burak Karaaslan - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Alp Özgün Börcek - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Gökhan Kurt - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Eray Karahacioglu - Gazi University Medical School, Department of Radiation Oncology, Gamma Knife Center, Ankara, Turkey
  • Memduh Kaymaz - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • M. Kemali Baykaner - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey
  • Aydin Pasaoglu - Gazi University Medical School, Department of Neurosurgery, Ankara, Turkey

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 060

doi: 10.3205/14dgnc456, urn:nbn:de:0183-14dgnc4563

Published: May 13, 2014

© 2014 Emmez 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

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Objective: Meningiomas are the second most common primary tumor of the brain. Although surgery is the gold standart treatment, it is associated with significant morbidity and mortality especially in skull base meningiomas. Complete surgical resection is difficult or impossible for meningiomas located in the skull base. Stereotactic radiosurgery is the safest and effective alternative to surgery. It can be used as a primary therapy for benign meningiomas as well as an adjuvant treatment for residual or recurrent tumors. The authors aim to analyze the results of stereotactic radiosurgery for benign meningiomas using Gamma Knife in 693 patients.

Method: Retrospective review of 693 patients with meningiomas who were treated in Gazi University Gamma Knife Center between 2004-2013 was performed. Grade 2 (26 patients) and 3 (6 patients) meningiomas were excluded. Total 661 patients (484 women, 177men) were reviewed. The median follow-up was 47.9 months.The location, the volume, the dose, number of shots, prescription rates, complications, response rates were analysed.

Results: The median age was 52.2 years (10-83). The median irradiated tumor volume was 6931mm3 (224-67600). The median tumor prescription ratio was 95.7%. The median dose was 14.2 Gy. The tumor control rate was: 98.5% (no growth in 89.5%, volume reduction in 9%). The location of the tumors were as follows: convexity 9.9%, parasagittal: 11.9%, petroclival%5.7, tentorial%10.1, foramen magnum 2.8%, sellar – parasellar 35.4%, 18.6% cerebellopontin cistern, other 4%. New neurological deficits or worsening of the symptoms occured in 13 (1.9%) patients. Non-specific symptoms like headache, dizziness etc were detected in 8.4% of the patients.

Conclusions: Stereotactic radiosurgery provides safe and effective way of tumor control for small and medium sized meningiomas. Patients with small tumors in skull base are the best candidates. Watch and see method is still a rational strategy for convexity and parasagittal tumors.