gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

The combined neurosurgical approach in a long-term study: Gamma Knife radiosurgery after resection of skull base meningioma

Neurochirurgische Kombinationsbehandlung im Langzeitverlauf: Gamma Knife nach Mikrochirurgie von Meningiomen der Schädelbasis

Meeting Abstract

  • corresponding author B.E. Lippitz - RWTH Aachen, Neurochirurgische Klinik
  • M. Söderman - Karolinska Hospital, Department of Neuroradiology, Stockholm, Sweden
  • E. Ulfarsson - Karolinska Hospital, Department of Neurosurgery, Stockholm, Sweden
  • B. Huffmann - RWTH Aachen, Neurochirurgische Klinik
  • C. Lindquist - Cromwell Hospital, Gamma Knife Center, London, Great Britain

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.07.04

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Lippitz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: To determine the long-term outcome after Gamma Knife radiosurgery of skull base meningioma with respect to tumour control and potential complications. The emphasis is on strategies to optimize a combined neurosurgical approach with planned resection and radiosurgery in order to reduce potential morbidity of either technique.

Methods: 40 consecutive patients with skull base meningioma, treated with Gamma Knife radiosurgery at the Karolinska Hospital, Stockholm were retrospectively analyzed. Anaplastic meningiomas were excluded. 22 patients (55%) had been operated before radiosurgery at various international centers. The median tumour diameter at the time of radiosurgery was 24 mm (10-60). Median prescription dose was 16 Gy. Dose plans were reviewed and dose parameters reviewed with regard to follow-up information.

Results: Clinical follow-up was available in 36/40 cases at median of 9.5 years (4.3-14.2) after Gamma Knife radiosurgery (median radiological follow-up: 8.6 years). Tumour control was achieved in 91% of cases (31/34). 6% (2/34) developed distant tumor recurrence outside the radiation field. 14% (5/36) developed secondary treatment related symptoms. Very few side effects were seen when modern dose planning and imaging standards with respect to threshold doses for sensitive structures were applied.

Conclusions: This retrospective analysis is one of the so far longest follow-up series of meningiomas treated with Gamma Knife radiosurgery. The data support the results from several short-term studies after radiosurgery and document the safe tumour control after Gamma Knife radiosurgery for meningioma even in the long-term perspective. The results emphasize the necessity for a cooperative neurosurgical management with a planned strategy consisting of microsurgery and radiosurgery. The complication rate is low when modern treatment strategies are applied.