Evaluation of Fractionated Radiotherapy and Gamma Knife Radiosurgery in Cavernous Sinus Meningiomas: Treatment Strategy

Metellus, P.; Régis, Jean; Muracciole, Xavier; Fuentès, S.; Dufour, Henry; Nanni, Isabelle; Chinot, Olivier; Martin, Pièrre‐Marie; Grisoli, F

doi:10.1227/01.neu.0000179924.76551.cd

Cited by 114 publications

(104 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3). These results are reasonably similar to those published for other FSR (Brell et al, 93% at 4 years [1] and radiosurgery studies (Roche et al, 92.8% at 5 years; [7], Pollock and Stafford, 98% at 1 year and 85% at 3 years [6], Mettelus et al, 94.4% at 5 and 10 years [8]); see Table 2.…”

Section: Tumor Controlsupporting

confidence: 90%

“…FSR is an attractive alternative because it facilitates both appropriate tumor control (1,3,8,12,13) and a significant reduction in functional symptoms. In our study, the best results were achieved for impaired visual acuity (67% improvement).…”

Section: Discussionmentioning

confidence: 99%

“…An overview is provided in Table 1. The mean patient age during treatment was 56 years (range, 30-73); 84% of the patients treated were female, which is typical for this type of pathology (1,4,(7)(8)(9). Twenty-six percent of the patients were initially treated with what was assumed to be complete surgery.…”

Section: Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

Litré

Colin

Noudel

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose: We discuss our experiences with fractionated stereotactic radiotherapy (FSR) in the treatment of cavernous sinus meningiomas. Methods and Materials: 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. Ó 2009 Elsevier Inc.

show abstract

Section: Tumor Controlsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

Litré

Colin

Noudel

et al. 2009

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

show abstract

“…External-beam radiation therapy 2,11,32,35,36,38,53,55 as well as stereotactic radiosurgery [3][4][5][6]12,14,[16][17][18][19][20]22,26,27,30,31,33,34,37,40,41,[43][44][45][46]48,54,58,60,61,63,64 have become viable adjuvant treatment as well as primary treatment modalities for many meningiomas. Their use is supported by high rates of tumor control and a low incidence of complications.…”

mentioning

confidence: 99%

Gamma Knife surgery for parasellar meningiomas: long-term results including complications, predictive factors, and progression-free survival

Williams¹,

Yen²,

Starke³

et al. 2011

JNS

View full text Add to dashboard Cite

Object. Stereotactic radiosurgery serves as an important primary and adjuvant treatment option for patients with many types of intracranial meningiomas. This is particularly true for patients with parasellar meningiomas. In this study, the authors evaluated the outcomes of Gamma Knife surgery (GKS) used to treat parasellar meningiomas.Methods. The study is a retrospective review of the outcomes in 138 patients with meningiomas treated at the University of Virginia from 1989 to 2006; all patients had a minimum follow-up of 24 months. There were 31 men and 107 women whose mean age was 54 years (range 19-85 years). Eighty-four patients had previously undergone resection. The mean pre-GKS tumor volume was 7.5 ml (range 0.2-54.8 ml). Clinical and radiographic evaluations were performed, and factors related to favorable outcomes in each case were assessed.Results. The mean follow-up duration was 84 months (median 75.5 months, range 24-216 months). In 118 patients (86%), the tumor volume was unchanged or had decreased at last follow-up. Kaplan-Meier analysis demonstrated radiographic progression-free survival at 5 and 10 years to be 95.4% and 69%, respectively. Fourteen patients (10%) developed new cranial nerve palsies following GKS. Factors associated with tumor control included younger age, a higher isodose, and smaller tumor volume. A longer follow-up duration was associated with either a decrease or increase in tumor volume. Fourteen patients (10%) experienced new or worsening cranial nerve deficits after treatment. Factors associated with this occurrence were larger pretreatment tumor volume, lower peripheral radiation dose, lower maximum dose, tumor progression, and longer follow-up.Conclusions. Gamma Knife surgery offers an acceptable rate of tumor control for parasellar meningiomas and accomplishes this with a low incidence of neurological deficits. Radiological control after radiosurgery is more likely in those patients with a smaller tumor volume and a higher prescription dose. (DOI: 10.3171/2011.1.JNS091939) keY WorDs • stereotactic radiosurgery • parasellar meningioma • skull base • cavernous sinus 1571Abbreviations used in this paper: GKS = Gamma Knife surgery; PFS = progression-free survival.

show abstract

“…4,5,10,23,35,[38][39][40][44][45][46] The incidence of visual deterioration following fractionated stereotactic radiotherapy in one study was 3%.…”

mentioning

confidence: 99%

Technical nuances in the management of tuberculum sellae and diaphragma sellae meningiomas

Nanda

Ambekar²,

Javalkar³

et al. 2013

FOC

View full text Add to dashboard Cite

Object Tuberculum sellae meningiomas (TSMs) and diaphragma sellae meningiomas (DSMs) are challenging lesions to treat due to their proximity to neurovascular structures. Methods The authors reviewed the medical records of patients who underwent surgical excision of TSMs and DSMs from 1990 to 2013. They also describe the technical strategies used to minimize injury to the optic apparatus, vascular structures, and pituitary stalk. Results Twenty-four patients with TSM and 6 patients with DSM were included in the study. Seventy percent of the tumors were large (≥ 5 cm). The pterional approach was employed in most cases. Optic canal involvement was observed in 4 patients. Twenty-one patients (70%) had visual dysfunction before surgery. At follow-up (median 18 months), visual improvement was noted in 10 (47.6%) of 21 patients. Gross-total excision was achieved in 22 patients (91.6%) with TSM and 5 (83.3%) with DSM. At last follow-up, 28 patients (93.3%) had a Glasgow Outcome Scale score of 5. There were no deaths in this series. Conclusions Tuberculum and diaphragma sellae meningiomas present a unique subset of tumors due to their location. They can be safely excised with minimal morbidity and mortality using microsurgical techniques. Attention to technical details during surgery leads to greater respectability and superior visual outcome.

show abstract

Evaluation of Fractionated Radiotherapy and Gamma Knife Radiosurgery in Cavernous Sinus Meningiomas: Treatment Strategy

Cited by 114 publications

References 68 publications

Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

Fractionated Stereotactic Radiotherapy Treatment of Cavernous Sinus Meningiomas: A Study of 100 Cases

Gamma Knife surgery for parasellar meningiomas: long-term results including complications, predictive factors, and progression-free survival

Technical nuances in the management of tuberculum sellae and diaphragma sellae meningiomas

Contact Info

Product

Resources

About