Artikel
Volume reduction of meningiomas after Gamma Knife radiosurgery
Volumenreduktion von Meningiomen nach Gamma-Knife-Behandlung
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Autoren
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Otto Bundschuh
- INI - International Neuroscience Institute, Hannover
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G. C. Feigl
- INI - International Neuroscience Institute, Hannover
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A. Gharabaghi
- INI - International Neuroscience Institute, Hannover
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M. Samii
- INI - International Neuroscience Institute, Hannover
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G. A. Horstmann
- Gamma Knife Zentrum, Krefeld
| Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
Meningiomas represent about 18 % of all intracranial brain tumours. There are numerous studies on the treatment options of meningiomas evaluating results of surgery, radiotherapy, embolization, stereotactic radiosurgery and any multimodal combinations of these treatment options. Studies on stereotactic Gamma Knife radiosurgery focus mostly on lack of growth of meningiomas after treatment and not on the potential effect of volume reduction of these tumours. In this retrospective study we made it our objective to evaluate the volume reducing effects of Gamma Knife treatment in meningioma patients with and without previous surgical treatment.
Methods
A group of 127 patients with a mean age of 56 years (ages 24 to 82) with a total number of 134 meningiomas (113 WHO grade 1 and 14 WHO grade 2) were included in this study. The strategy was to first perform surgery (81 patients) in order to reduce the tumour volume whenever necessary followed by stereotactic radiosurgery treatment with a Gamma Knife C model. MRI follow-up examinations with volumetric tumour analysis were performed 6 months after treatment and than annually.
Results
The tumour volumes ranged from less than 5cc to more than 15cc with a mean of 7.3cc. The mean follow-up time after Gamma Knife treatment was 22.4 months (30-57.4 months). The mean volume reduction achieved with Gamma Knife radiosurgery was more than 70%. The mean prescription dose was 13.5 Gy (10-18 Gy). A reduction of tumour volume was achieved in 100 tumours (74.6%), in 29 tumours (21.6%) growth was stopped and only 4 tumours (3.7%) showed a volume increase.
Conclusions
The efficacy of stereotactic radiosurgery treatment of meningiomas showed excellent results within a very short time of follow-up. The results showed statistically significant (>10%) tumour volume reduction. Evaluation of these results showed that the Gamma Knife contributed to tumour volume reduction usually achieved only by conventional surgical treatment. Further studies using this treatment strategy should follow, especially with evaluation of long-term side effects.
