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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Radiosurgical treatments of meningeomas

Meeting Abstract

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  • Klaus Hamm - CyberKnife Centrum Mitteldeutschland im Helios Klinikum Erfurt, Germany
  • Gunnar Surber - CyberKnife Centrum Mitteldeutschland im Helios Klinikum Erfurt, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.03.03

doi: 10.3205/16dgnc102, urn:nbn:de:0183-16dgnc1023

Published: June 8, 2016

© 2016 Hamm et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Whithout doubt microsurgical resection is the treatment of choice for meningeomas. But there are special cases with high risk of postoperative deficits, especially in the skull base region. In some cases the complete tumor removal cannot be achieved, therefore recurrences are more probably. For those patients a radiosurgical treatment may offer an additional or alternate option.

Method: 420 patients with 474 meningeomas having received a radiosurgical treatment (2000-2011) were evaluated, among them 164 (39%) with residual and 112 (27%) with recurrent meningeomas after 1-5 microsurgical resections. We investigated the results after a mean follow-up of 76 months (24-156). RS was applied in 101 cases (22%). The respective tumor volume ranged from 0.2 to 3.9 cm³. The other patients had larger tumor volumes up to 99.7 cm³ or a meningeoma compressing optical structures. Therefore 271 patients (59%) were treated with SRT in conventional fractions of 1.8 or 2 Gy single dose up to a total dose of 52.2-55.8 Gy. Hypofractionation with single fraction doses of 5 or 4 Gy was applied in 84 cases.

Results: The tumor control rate was found to be 93.9%. A partial tumor regression was proved in 218 (51.9%), no change in 176 (41.9%) and progression in 26 (6.2%) cases. Among the patients treated with SRT in single fractions of 2 or 1.8 Gy we have seen 7 of them with unusual reactions and temporary worsening of pre-existing symptoms. In the RS group MRI showed surrounding radiation effects after 6-12 months in 26 patients, however there were only temporary clinical side effects according to CTC grade I-II in 6 cases.

Conclusions: Radiosurgical treatments are effective for tumor control in meningeomas while the associated risk has been found to be low. In case of meningeomas compressing optical structures SRT is the treatment of choice. However, an interdisciplinary decision should be made for each patient.