title: Gamma Knife radiosurgery for meningiomas arising from the tentorium: a 22-year experience.
abstract: In order to evaluate long term clinical and imaging outcomes, the authors retrospectively reviewed our 22-year experience using stereotactic radiosurgery (SRS) for tentorial meningiomas. Thirty-nine patients with tentorial meningiomas underwent SRS using various Gamma Knife technologies between 1988 and 2010. The most common presenting symptoms were headache, dizziness or disequilibrium, and ataxia. The median tumor volume was 4.6 cm(3) (range 0.5-36.6 cm(3)) and the median radiation dose to the tumor margin was 14 Gy (range 8.9-18 Gy). The median follow-up period was 41 months (range 6-183 months). At the last imaging follow-up, tumor volumes decreased in 22 patients (57 %), remained stable in 13 patients (33 %), and increased in 4 patients (10 %). The progression-free survival after SRS was 97 % at 1 year, and 92 % at 5 years. At the last clinical follow-up, 35 patients (90 %) showed no change in symptoms, 1 patient (2 %) showed improvement of their neurologic symptom, and 3 patients (8 %) demonstrated worsening symptoms. The rate of symptom worsening after SRS was 5 % at 1 year, and 10 % at 5 years. Asymptomatic peritumoral edema after SRS occurred in 2 patients (5 %). Symptomatic adverse radiation effect developed in 2 patients (5 %). SRS for tentorial meningiomas provided long-term effective tumor control and a low risk of radiation related complications.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, Suite B-400, UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.
authors.forename: Seong-Hyun
authors.initials: SH
authors.lastname: Park
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kano
authors.forename: Ajay
authors.initials: A
authors.lastname: Niranjan
authors.forename: Edward
authors.initials: E
authors.lastname: Monaco
authors.forename: John C
authors.initials: JC
authors.lastname: Flickinger
authors.forename: L Dade
authors.initials: LD
authors.lastname: Lunsford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult