Gamma knife radiosurgery of meningiomas.
Fifty patients with meningiomas were treated during the initial 30 months experience using the 201 source cobalt-60 gamma knife at the University of Pittsburgh. The most frequent site of origin was the skull base. Stereotactic radiosurgery was the primary treatment modality in 16 (32%) patients with symptomatic tumors demonstrated by neuroimaging. Thirty-six patients (72%) had undergone at least one craniotomy, and 4 patients (8%) previously had fractionated external beam radiation therapy. The proximity of cranial nerves, vascular, pituitary and brainstem structures to the often convoluted tumor mass was crucial to dose selection. Follow-up imaging studies and clinical analysis of patients were performed at 6-month intervals. The actuarial 2-year tumor control rate was 96%. Only 2 patients have shown delayed tumor growth outside the radiosurgical treatment volume. To date, stereotactic radiosurgery proved to be a relatively safe and effective therapy for selected patients with symptomatic meningiomas, either as an adjuvant treatment to prior resection, or as a primary treatment alternative for patients whose advanced age, medical condition or high-risk tumor location mitigated against surgical resection.
Kondziolka
D
D
Department of Neurological Surgery, Presbyterian University Hospital, University of Pittsburgh, Pa.
Lunsford
L D
LD
Coffey
R J
RJ
Flickinger
J C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000188:drug therapy / Q000209:etiology; D011183:Postoperative Complications; D016634:Radiosurgery / Q000295:instrumentation; D014057:Tomography, X-Ray Computed