gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Follow-up of skull base meningiomas – Tumor volume regression after stereotactic radiotherapy

Verlaufsbeobachtung bei Schädelbasis-Meningeomen – Tumorvolumen-Regression nach stereotaktischer Radiotherapie

Meeting Abstract

  • corresponding author K. Hamm - Abteilung für stereotaktische Neurochirurgie und Radiochirurgie, HELIOS Klinikum Erfurt
  • M. Henzel - Klinik für Strahlentherapie, Philipps-Universität Marburg
  • M. W. Gross - Klinik für Strahlentherapie, Philipps-Universität Marburg
  • G. Kleinert - Abteilung für stereotaktische Neurochirurgie und Radiochirurgie, HELIOS Klinikum Erfurt
  • R. Engenhart-Cabillic - Klinik für Strahlentherapie, Philipps-Universität Marburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocDO.04.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc031.shtml

Veröffentlicht: 11. April 2007

© 2007 Hamm et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Consistently high tumor treatment rates (93-100%) were reported after radiosurgery (RS) or (fractionated) stereotactic radiotherapy (SRT) of skull base meningiomas. But the data about radiological regression are heterogenous (13-61%) caused by different definitions, which make only qualitative data analyses possible (regression in x% of the cases). An uniform standard permits a quantitative data analysis (x% tumor volume (TV) shrinkage). In the present study TV shrinkage was evaluated.

Methods: 94 patients treated with SRT (77), hypofractionated SRT (10) and RS (7) in two departments, were examined under the same conditions before and after treatment. Fat saturated axial T1-weighted contrast-enhanced MRI scans with 1-3 mm slice thickness were used. After image fusion, TV was delineated slice by slice, analyzing TV shrinkage 3-dimensionally by the planning system. The median follow-up was 24 months.

Results: We found a TV shrinkage in 91.5% of the 94 cases using the 3-dimensionally volumetric analysis. The initial mean TV (mTV) was 12.8 cm3. 6, 12, 18 and 24 months after SRT/RS mTV shrank about 18.1%, 26.2%, 30.3% and 39.4%, respectively – after 6-24 months about 30% (p<0.0001). With regard to the 6-month intervals, TV reduction decreased continuously towards a steady state (p<0.0001). Younger age (p<0.05) and previous operations (p=0.03) were determining factors. There was no correlation between TV reduction and the prescribed dose or histological subtypes.

Conclusions: SRT as an effective treatment with low side effects is highly recommended for skull base meningiomas. An approximately 30% TV shrinkage can be observed 2 years after SRT/RS. Younger age and previous operations are determining factors. The prescribed dose or histological subtypes do not affect TV shrinkage.