title: Radiosurgical planning of meningiomas: compromises with conformity.
abstract: The radiosurgical planning of meningiomas frequently necessitates compromises between irradiating tumour and risking damage to adjacent structures. In selected cases, we resolved this by excluding part of the tumour from the prescription isodose volume. Most of these compromises or 'suboptimal' plans achieved growth control. Growth control could not be related to conformity indices or to various measures of the radiation dose received by the meningioma. Examining recurrences, 75% arose from dura outside the original treatment field. These findings are discussed in terms of dose prescription protocols and the use of conformity indices in planning. The importance of the dural origin of meningiomas is well established in surgical practice, as reflected by Simpson's grades, but may be equally significant in radiosurgical practice.
authors.affiliation: National Centre for Stereotactic Radiosurgery, Royal Hallamshire Hospital, Sheffield, UK. Jeremy.Rowe@sth.nhs.uk
authors.forename: Jeremy G
authors.initials: JG
authors.lastname: Rowe
authors.forename: Lee
authors.initials: L
authors.lastname: Walton
authors.forename: Paul
authors.initials: P
authors.lastname: Vaughan
authors.forename: Irfan
authors.initials: I
authors.lastname: Malik
authors.forename: Matthias
authors.initials: M
authors.lastname: Radatz
authors.forename: Andras
authors.initials: A
authors.lastname: Kemeny
mesh_terms: D003657:Decision Making; D006801:Humans; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D011300:Preoperative Care; D016634:Radiosurgery / Q000379:methods* / Q000592:standards*; D011880:Radiotherapy Planning, Computer-Assisted