Fractionated stereotactic radiotherapy treatment of cavernous sinus meningiomas: a study of 100 cases.
OBJECTIVE
We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous sinus meningiomas.


METHODS
From 1995 to 2006, we monitored 100 patients diagnosed with cavernous sinus meningiomas; 84 female and 16 male patients were included. The mean patient age was 56 years. The most common symptoms were a reduction in visual acuity (57%), diplopia (50%), exophthalmy (30%), and trigeminal neuralgia (34%). Surgery was initially performed on 26 patients. All patients were treated with FSR. A total of 45 Gy was administered to the lesion, with 5 fractions of 1.8 Gy completed each week. Patient treatment was performed using a Varian Clinac linear accelerator used for cranial treatments and a micro-multileaf collimator.


RESULTS
No side effects were reported. Mean follow-up period was 33 months, with 20% of patients undergoing follow-up evaluation of more than 4 years later. The tumor control rate at 3 years was 94%. Three patients required microsurgical intervention because FSR proved ineffective. In terms of functional symptoms, an 81% improvement was observed in patients suffering from exophthalmy, with 46% of these patients being restored to full health. A 52% improvement was observed in diplopia, together with a 67% improvement in visual acuity and a 50% improvement in type V neuropathy.


CONCLUSIONS
FSR facilitates tumor control, either as an initial treatment option or in combination with microsurgery. In addition to being a safe procedure with few side effects, FSR offers the significant benefit of superior functional outcomes.
Litré
Claude Fabien
CF
Department of Neurosurgery, Maison Blanche Hospital, Reims, France. fabien.litre@mac.com
Colin
Philippe
P
Noudel
Remy
R
Peruzzi
Philippe
P
Bazin
Arnaud
A
Sherpereel
Bernard
B
Bernard
Marie Helene
MH
Rousseaux
Pascal
P
D000328:Adult; D000368:Aged; D002426:Cavernous Sinus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden