gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Long-term outcome after gamma knife radiosurgery of cavernous sinus meningiomas

Meeting Abstract

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  • M. Qweider - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • H. Clusmann - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
  • B. C. Huffmann - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.02.03

DOI: 10.3205/12dgnc031, URN: urn:nbn:de:0183-12dgnc0315

Published: June 4, 2012

© 2012 Qweider et al.
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Outline

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Objective: To evaluate long-term clinical outcome and response after gamma knife radiosurgery (GKRS) of cavernous sinus meningiomas.

Methods: In 52 consecutive patients harboring meningiomas involving the cavernous sinus GKRS had been performed at least five years prior to assessment of this study. One patient was lost to follow-up review, leaving 51 analyzable patients with clinical and imaging follow-up. Forty two patients (82%) underwent adjuvant radiosurgery after one or more operations. In nine cases (18%) GKRS was the primary treatment for tumors < 18 cm3. The median age was 53 years, the male to female ratio 11:40. A median dose of 13 Gy (range 12–15 Gy) was applied to the tumor margin. The optic pathways received less than 8 Gy in all cases. Pre- and post-interventional neurological symptoms were examined by interview or questionnaire: symptoms as headache, nausea, vertigo, diplopia, visual and olfactory disturbances were requested.

Results: At follow-up examination (15–98 months, median 64) neurological status was improved in 48% of the patients and stable in 46%. Mild transient symptoms such as trigeminal dysaesthesia were reported in 6%. However, no permanent neurological aggravation was observed at follow-up. Tumor volumes as measured in MRI (1, 4–18.1 cm3, median 6.9 cm3) decreased in 60% and remained unchanged in 36%. Two patients (4%) had out of field recurrences after more than 60 months follow-up.

Conclusions: GKRS provides a safe and effective management of cavernous sinus meningiomas. GKRS as primary treatment can be considered as an alternative to microsurgical removal of small to medium sized (smaller than 18 cm3) cavernous sinus meningiomas without compression of the optic pathways. In case of extensive meningiomas it should be proposed as adjuvant to surgery.