Stereotactic radiosurgery for skull base meningioma.
Stereotactic radiosurgery is now a treatment option for meningiomas, especially for high-risk patients such as those with skull base lesions. The clinical outcomes were retrospectively analyzed of stereotactic radiosurgery using the Leksell Gamma Knife((R)) performed for 98 patients with 106 skull base meningiomas at the University of Tokyo Hospital between June 1990 and April 2006 and followed up for more than a year. After a median follow-up period of 53.2 months (range 12.2-204.4 months), local tumor control rates were 86.9% and 78.9% at 5 years and 10 years, respectively. Tumors with volume of 4 cm(3) or smaller (97.5% vs. 76.1% at 5 years, p = 0.001) and tumors completely included within the isodose line of 14 Gy or more (97.5% vs. 67.2% at 5 years, p = 0.0006) had higher local control rates. Postoperative residual tumors treated by stereotactic radiosurgery were controlled in all 25 cases. Cranial nerve deficits were improved, stable, and deteriorated in 12, 64, and 3 patients, respectively, after stereotactic radiosurgery. Stereotactic radiosurgery was effective treatment method for local control of skull base meningiomas, especially for small or postoperative residual tumors. Correct combination of microsurgery and radiosurgery leads to excellent local control.
Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan. ki-tky@umin.ac.jp
Hiroshi
H
Igaki
Keisuke
K
Maruyama
Tomoyuki
T
Koga
Naoya
N
Murakami
Masao
M
Tago
Atsuro
A
Terahara
Masahiro
M
Shin
Keiichi
K
Nakagawa
Kuni
K
Ohtomo
D000293:Adolescent; D000328:Adult; D000368:Aged; D003389:Cranial Nerve Diseases / Q000453:epidemiology / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011829:Radiation Dosage; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology / Q000601:surgery; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult