title: [Gamma knife radiosurgery for skull base meningiomas: the treatment results and patient satisfaction expressed in answers to a questionnaire].
abstract: Skull base meningiomas can be treated by radiosurgery with low morbidity. We evaluated the effectiveness of gamma knife radiosurgery for skull base meningiomas. We also evaluated patient satisfaction through answers to a questionnaire. We treated 77 patients of skull base meningiomas using gamma knife radiosurgery from January 1994 to June 1998. Among these patients, 73 patients were able to be followed up from 6 to 60 months (average 25 months). The diagnosis was made by operations on 39 patients (53%), and on magnetic resonance imagings in 34 patients (47%). 21 patients (28.7%) had residual tumors after operations and 18 patients (24.3%) had recurrence after operations. 40% of neurological deficits occurred after previous operations and 20% of the patients were asymptomatic. The locations of the tumors were mainly the cavernous sinus region in 35 patients and the petroclival region in 20 patients. The tumor sizes were 8.6 to 58.3 mm (average 24.7 mm) and five cases of tumors with a mean diameter above 40 mm were treated by two-staged radiosurgery. Treatment volume was 0.3 to 31 ml (average 9.8 ml). The treatment dose was 8 to 16 Gy (average 11.2 Gy) at the tumor margin. The tumor decreased in size in 50 patients (68%) and was unchanged in 20 patients (28%) and we were able to achieve 96% tumor growth control. The clinical symptoms improved in 22 patients (30.1%) and were unchanged in 47 patients (64.4%) and only 4 patients (5.5%) showed deterioration. 50 patients (68%) felt clinical improvement and only 3 patients (4%) sensed deterioration. 58 patients (79%) were able to continue their previous work. Gamma knife radiosurgery has a very low morbidity rate and enables good tumor control, and patients with skull base meningiomas express satisfaction with the treatment results.
authors.affiliation: Department of Neurosurgery, Osaka City General Hospital, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Iwai
authors.forename: K
authors.initials: K
authors.lastname: Yamanaka
authors.forename: H
authors.initials: H
authors.lastname: Nakajima
authors.forename: T
authors.initials: T
authors.lastname: Yasui
authors.forename: H
authors.initials: H
authors.lastname: Kishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000523:psychology / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D016634:Radiosurgery; D019292:Skull Base Neoplasms / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome