Stereotactic radiosurgery. VII. Radiosurgery versus conventionally-fractionated radiotherapy in the treatment of cavernous sinus meningiomas.
Twenty-eight patients with meningiomas involving the cavernous sinus were referred to the radiosurgical service at St. Bartholomew's Hospital 1989-1998. The majority (8/13) of patients with small (< 3 cm diameter) tumours received radiosurgery whereas the majority of large tumours (> 3 cm diameter; 12/15) received conventionally-fractionated radiotherapy. Other treatment recommendations were fractionated radiosurgery (one case) and conventionally-fractionated radiotherapy to the whole meningeal base and a radiosurgery boost (three cases). Fractionated radiosurgery is optimal where the target volume is small, but abuts critically sensitive nervous system. There have been no progressions of disease at relatively early follow-up. It is argued that subtotal excision followed by appropriate dose radiation therapy is often a strong competitor to attempted radical excision given the attendant morbidity of this latter operation for meningiomas at this site. Patients referred for radiation therapy are best served by a department with both radiosurgery and conventional radiation therapy facilities.
Sibtain
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A
Department of Clinical Oncology, St Bartholomew's Hospital, London, UK.
Plowman
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PN
D000328:Adult; D000368:Aged; D002426:Cavernous Sinus / Q000601:surgery*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D008579:Meningioma / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed