gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Long-term experience in 121 patients after gamma knife radiosurgery for benign skull base meningiomas

Langzeitergebnisse bei 121 Patienten nach Radiochirurgie bei benignen Schädelbasismeningeomen

Meeting Abstract

  • corresponding author F. Unger - Universitätsklinik für Neurochirurgie, Graz/A
  • S. Eustacchio - Universitätsklinik für Neurochirurgie, Graz/A
  • G. Papaefthymiou - Universitätsklinik für Neurochirurgie, Graz/A

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-05.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0013.shtml

Published: May 4, 2005

© 2005 Unger et al.
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Outline

Text

Objective

Microsurgical excision with preservation of juxtaposed neuro-vascular structures is considered the treatment of choice for skull base meningiomas, but there exists a great controversy regarding surgical resectability, potential risk for subsequent postoperative cranial nerve deficit (CND) and the role of adjuvant or adjunctive treatment options. In this study we evaluated the effect of gamma knife radiosurgery (GKRS) in 121 patients with benign basal meningiomas after a follow-up of 6 to 10 years.

Methods

Sixty patients had undergone open resections prior to radiosurgical treatment and 61 patients received GKRS as primary treatment. Tumour volumes of 0.5 to 89.9 ccm (median 6.8 ccm) received a median marginal dose of 13 Gy (range 7-25 Gy) at the covering 25% to 80% isodose volume curves (median 45%).

Results

Neuroradiological controls demonstrated decreased tumour size in 73 patients (60.3%), stable meningioma volume in 47 cases (38.9%) and tumour enlargement in one patient (0.8%). The tumour control rate was 98.3%. Clinically, 54 patients (44.6%) improved and 61 cases (50.4%) remained unchanged. Four patients (3.3%) showed temporary and two patients (1.7%) permanent neurological deterioration (unrelated to tumour or treatment in one patient). Two patients (1.7%) developed radiation-induced new or aggravated pre-existent CND (1 transient, 1 permanent) and two patients (1.7%) required further surgical resection.

Conclusions

Radiosurgery performed with current techniques proved to be an effective method for growth control of skull base meningiomas with both a low mortality rate and a good quality of life. An increasing percentage of patients will undergo radiosurgery as accessibility to this alternative increases, and more data regarding long-term follow-up are available. It is a postoperative complementary treatment for partially removed tumours. Accordingly, radiosurgery is a useful method for the management of properly selected patients.