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62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Stereotactic Micro-Multi-Leaf-LINAC-radiosurgery for intracranial meningiomas

Meeting Abstract

  • F. El Majdoub - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln, Köln
  • M. Elawadi - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln, Köln
  • C. Bührle - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln, Köln
  • M. El Khatib - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf, Düsseldorf
  • M. Hoevels - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln, Köln
  • R.P. Müller - Abteilung für Onkologische Bestrahlung, Klinikum der Universität zu Köln, Köln
  • V. Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln, Köln
  • M. Maarouf - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Klinikum der Universität zu Köln, Köln

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.04.09

DOI: 10.3205/11dgnc207, URN: urn:nbn:de:0183-11dgnc2073

Veröffentlicht: 28. April 2011

© 2011 El Majdoub 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Meningiomas are benign, slowly progressive neoplasms that often present the opportunity for a permanent cure. Microsurgery is the treatment of choice in most cases. Radiosurgery is emerging as a different, non-invasive modality for the treatment of meningiomas. We present the clinical and radiological outcome of a consecutive series of patients with meningiomas treated by LINAC-Radiosurgery using the Micro-Multi-Leaf Collimator technique (µMLC).

Methods: Between May 2001 and July 2009, 78 patients (24 male and 54 female, range: 20.1 to 81 years, median: 56.8 years) with 87 intracranial meningiomas (78 WHO I°, 7 WHO II°, 2 WHO III°) were treated at our institution with µMLC-LINAC Radiosurgery, either as a primary or salvage treatment following one or more microsurgical procedures. The locations of the tumors were the falx 20 (23%), sphenoid wing 14 (16.1%), cavernous sinus 11 (12.6%), CPA 8 (9.2%), tentorium 8 (9.2%), convexity 7 (8.1%) and other locations 19 (21.8%). The median tumor volume was 4.8ml (range: 0.2 to 18.3 ml). The median tumor surface dose, maximal dose and therapeutic isodose were 12Gy, 16 Gy and 75% respectively after a median follow-up period of 76.7 months (range: 11.8 to 109.1 months).

Results: There was clinical improvement in 24 patients improved (30.8%), 49 patients were stable (62.8%), 3 patients had treatment-related temporary complaints (3.8%); two patients developed vertigo and one had a left sided hemihypesthesia. All these complaints disappearedcompletely after steroid medication within two weeks. Two patients (2.6%) developed permanent trigeminal neuralgia. Follow-up MRI showed a partial remission in 21 tumors (24.1%) and a stable tumor size in 64 cases (73.6%). Two patients showed tumor progression (one WHO I° and one WHO III° meningioma). At the end of follow-up (July 2010), five patients had died; four due to old age and one patient due to pulmonary embolism. Overall actual 5- and 8-year survival rates after radiosurgery were 97% and 88% respectively. There was no treatment-related mortality.

Conclusions: µ-MLC-LINAC-Radiosurgery for intracranial meningiomas is a safe and effective treatment for complex small to moderate-sized meningiomas.