gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Article

Send article

Long term follow-up of cavernous sinus meningiomas after stereotactic radiosurgery

Meeting Abstract

Search Medline for

  • Daniel Ruess - Klinik für Stereotaxie und funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Fenja Fritsche - Klinik für Stereotaxie und funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Stefan Grau - Klinik und Poliklinik für Allgemeine Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Harald Treuer - Klinik für Stereotaxie und funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland
  • Martin Kocher - Uniklinik Köln, Strahlenklinik, Köln, Deutschland
  • Maximilian I. Ruge - Klinik für Stereotaxie und funktionelle Neurochirurgie, Zentrum für Neurochirurgie, Uniklinik Köln, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.27.05

doi: 10.3205/17dgnc167, urn:nbn:de:0183-17dgnc1670

Published: June 9, 2017

© 2017 Ruess 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: Microsurgical resection of cavernous sinus meningiomas (CSM) is challenging with a high percentage of recurrence due to incomplete resection (>10% reported recurrence rate after Simpson Grade II and >20% after Grade III resections) and/or permanent, partly severe cranial nerve deficits. Stereotactic radiosurgery (SRS) has evolved as alternative first-line treatment for SCM. Here, we report about the long term clinical and radiological follow-up of an unique cohort of patients with CSM treated with LINAC based SRS.

Methods: In this single center retrospective analysis we included all patients with SCM who underwent single fraction LINAC SRS between 1993 and 2012 and had a minimum follow-up of 3 months. We evaluated tumor control (no further intervention needed) by the Kaplan-Meier method. Additionally, patient data were analyzed in terms of clinical symptom control and incidence of complications or unexpected side effects rated by Common Terminology Criteria for Adverse Events (CTCAE; v4.03).

Results: 82 patients with 83 tumors (f/m =62/20, median age 53 ± 11, range 33-81 years) were identified. Mean tumor volume was 5.8 ± 3.5 cm3 (range, 0.6-16 cm3), the mean marginal dose was 12 ± 2 Gy (range, 7.0-18.75 Gy) at isodose levels of 64 ± 17% (range, 30-85%). Median follow-up (FU) was 57 months (range, 3-226 months). Tumor control was 100% after 6 and 12 months, 97% after 5-years and 94% after 10 years. Symptoms prior to SRS remained stable in 88% (n=73), improved in 3.6% (n=3) and deteriorated in 2.4% (n=2) at last follow-up. Four patients (4.8%) report about adverse events CTCAE grade 1 (headache n=2, somnolence n=1, trigeminus disorder n=1).

Conclusion: SRS for SCM provides reliable long term tumor control without considerable permanent side effects. Thus, SRS should be taken into account when counselling patients harbouring CSM.