Gamma knife radiosurgery of meningiomas in the cavernous sinus region.
For 6 years (1992-1998) we have treated 67 patients with cavernous sinus meningioma using the Leksell gamma knife in the Hospital Na Homolce, Prague. The age of the patients ranged between 19-82 years, median 57 years. Radiosurgery was the primary treatment in 64.2% of the patients, in the rest a microsurgical resection preceded. The volume of the tumour ranged from 0.9-31.4 cm3, median 7.8 cm3. The meningioma was distant from the optic tract in 58% of the cases, in 12% of the cases there was a contact with the tumour and the optic tract without its compression and in 30% of the cases there was a compression of the optic tract caused by the meningioma. The dose to the tumour margin ranged from 10-14 Gy, median 12 Gy. The follow up was available in 53 patients, in intervals of 2-60 months, median 19 months. There was no change in the tumour volume in 48% of the cases, in 52% of the cases a decrease of the tumour volume occurred. No increase of the tumour volume was observed. Clinical symptoms and signs improved in 35.8% of the patients, temporary morbidity was 3.8%. The mortality of the treatment was zero. Hitherto, the results of gamma knife radiosurgery of cavernous sinus meningioma have proved its safety and efficiency, although long term experience with a large group of patients is missing. Advances in neuroradiology and radiosurgical technique have allowed us to treat tumours with a closer contact to the optic tract and nerves compared with the past.
Department of Stereotactic and Radiation Neurosurgery, Hospital Na Homolce, Prague, Czech Republic.
R
R
Liscák
G
G
Simonová
J
J
Vymazal
L
L
Janousková
V
V
Vladyka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome