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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Hypofractionated radiosurgery for benign skull base tumors

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  • Daniel Rueß - Uniklinik Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Christina Hamisch - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Stefan Grau - Uniklinik Köln, Klinik für Allgemeine Neurochirurgie, Köln, Deutschland
  • Karolina Jablonska - Uniklinik Köln, Klinik für Strahlentherapie, Köln, Deutschland
  • Martin Kocher - Uniklinik Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Harald Treuer - Uniklinik Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland
  • Maximilian I. Ruge - Uniklinik Köln, Klinik für Stereotaxie und funktionelle Neurochirurgie, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV211

doi: 10.3205/18dgnc214, urn:nbn:de:0183-18dgnc2142

Published: June 18, 2018

© 2018 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: The use of single fraction stereotactic radiosurgery (SRS) is limited by tumor size (>3cm) and/or close proximity to critical structures (e.g. cranial nerves/optical pathway/pituitary gland). Here we present data regarding hypofractionated SRS (hSRS) for the treatment of benign skull base tumors either > 3 cm and/or neighboring critical structures.

Methods: In this single center retrospective analysis, we consecutively included all patients with benign skull base tumors (meningeomas, pituitary adenomas, schwannomas) who underwent Cyberknife® hSRS using a tumor surface dose of 25 Gy applied in five fractions (Isodoselevel 70-80%) between 2012 and 2016 with a minimum follow-up of 6 months. Patient data were analyzed in terms of tumor control (defined as no further intervention required), symptom control (stable clinical condition) and incidence of early and late treatment related complications (rated by using the Common Terminology Criteria for Adverse Events, CTCAE; v4.03).

Results: 29 patients (f:m = 18:11, median age = 52 years) were treated with hSRS. Tumor entities were meningiomas (n=18), pituitary adenomas (n=7),vestibular(n=2) and trigeminal nerve schwannomas (n=2). 41% underwent surgery prior hSRS. Mean tumor volume was 7.9 ml (0.6-20.8 ml). Median follow-up was 23 months (6-50 months).

The actual 1-, 2-, and 4-year tumor control rate was 100%, 94.5% and 94.5%, respectively. Symptoms improved in 17% of cases (diplopia, n=3, CN V affection, n=2). Complications (CTCAE grade I and II) were observed in 6.8% of the cases (headache n=1, imbalance n=1).

Conclusion: Our treatment results show low rates of mild adverse events and encouraging tumor control rates which are consistent with those reported in literature.