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

LINAC-radiosurgery for the treatment of skull base meningiomas

Meeting Abstract

  • F. E. Majdoub - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Uniklinik Köln
  • M. E. El-Khatib - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf
  • H. Treuer - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Uniklinik Köln
  • R. P. Müller - Klinik und Poliklinik für Strahlentherapie, Uniklinik Köln
  • V. Sturm - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Uniklinik Köln
  • M. Maarouf - Klinik für Stereotaxie und Funktionelle Neurochirurgie, Uniklinik Köln

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.02.05

DOI: 10.3205/12dgnc033, URN: urn:nbn:de:0183-12dgnc0333

Published: June 4, 2012

© 2012 Majdoub et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: We present our long-term results of a consecutive series of patients with skull base meningiomas treated by LINAC-Radiosurgery.

Methods: Between August 1991 and July 2011, 129 patients (m:f = 39:101; median age, 51.9 years; range, 9.7–80.2 years) with 134 skull base meningiomas (81 WHO I, 9 WHO II, 2 WHO III, 42 Tumors with no histology) were treated with LINAC Radiosurgery at our institution, either as a primary (n = 42) or salvage treatment following one or more microsurgical procedures (n = 92). The meningiomas were located at the sphenoid wing/ sinus cavernosus (n = 104, 77.6%), petroclival (n = 18, 13.4%), olfactorial (n = 8, 6%) and in the cerebellopontine angle (n = 4, 3%). The median tumor volume was 5.7 ml (range, 0.2–51.4 ml). The median tumor surface dose, maximal dose and therapeutic isodose were 12 Gy, 29.1 Gy and 65%, respectively.

Results: For retrospective evaluation we included 112 patients (117 tumors) with a minimum radiological follow-up of 12 months. After a median follow-up of 56.7 months (range, 12.1–231.4 months) 68 patients (60.7%) improved in their clinical status (paresis of N. abducens, seizures, facial paresis, and hemiparesis; 35 patients (31.2%) remained stable, 7 patients (6.3%) had treatment-related temporary complaints; 2 patients developed vertigo, another 2 had double visions, 2 patients exhibited seizures and 1 had a left-sided hemihypesthesia. All complaints recovered completely after steroid medication within one month. Two patients (1.8%) developed permanent medication controlled trigeminal neuralgia. Follow-up MR images showed partial remission in 41 tumors (35%) and a stable tumor in 66 cases (56.4%). Five patients (4.3%), all of them with high grade meningiomas showed a tumor progression (3 WHO II and 2 WHO III meningioma). At the end of follow-up (July 2011) the actuarial 5-, 10- and 15-year progression-free survival after radiosurgery were each 94%, respectively. There was no treatment-related mortality.

Conclusions: LINAC-Radiosurgery for skull base meningiomas yields a high long-term local tumor control. The treatment-related morbidity is low.