Gamma Knife Stereotactic Radiosurgery for Grade 2 Meningiomas

Refaat, Tamer; Gentile, Michelle S.; Sachdev, Sean; Dalal, Prarthana; Butala, Anish A.; Gutiontov, Stanley I.; Helenowksi, I.; Lee, Plato; Sathiaseelan, V.; Bloch, Orin; Chandler, James R.; Kalapurakal, John A.

doi:10.1055/s-0036-1597834

Cited by 15 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prescription dose administered to the lesion also determines the rate of control among meningiomas. Tumours receiving less than doses of 12-13.4 Gy have been reported to display a significantly higher risk of recurrence than tumours receiving higher doses [15,16,[18][19][20]. Our data report a similar observation, with 40% rate of progression among tumours that received less than 12 Gy compared with 16.7% of tumours that received a dose in excess of 12 Gy.…”

Section: Outcomes Of Gkrs In Meningioma and Factors Predicting Poor O...supporting

confidence: 79%

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc

Goyal-Honavar,

Pateriya,

Chauhan

et al. 2024

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Introduction: Meningiomas are the most common primary intracranial tumour. Gamma knife radiosurgery (GKRS) is a frequently employed non-invasive method of treatment, with good remission rates and low morbidity in literature. However, the role of GKRS in the management of “large” meningiomas is unclear, with reported outcomes that vary by centre. We aimed to assess the factors that influence long-term outcomes following GKRS in meningiomas >10 cc in volume. Methods: A retrospectively analysed all patients with meningiomas exceeding 10 cc in volume who underwent GKRS between January 2006 and December 2021 at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. Demographic, clinical, radiological, and follow-up data were acquired, and factors associated with progression following GKRS were assessed. Results: The cohort comprised 76 patients 29 males (38.2%) and 47 females (61.8%) with a mean age of 46.3 ± 11.02 years. Thirty-nine patients had been previously operated (51.3%). Meningiomas were most frequently located in the parasagittal region (26 tumours, 34.2%) and sphenopetroclival region (23 tumours, 30.3%), with mean lesion volume of 12.55 ± 5.22 cc, ranging 10.3 cc–25 cc. The mean dose administered to the tumour margin was 12.5 Gy ± 1.2 Gy (range 6–15 Gy). The median duration of clinical follow-up was 48 months, over which period radiological progression occurred in 14 cases (20%), with unchanged tumour volume in 20 cases (28.6%) and reduction in size of the tumour in 36 cases (51.4%). Progression-free survival after GKRS was 72% at 5 years, was significantly poorer among meningiomas with tumour volume >14 cc (log-rank test p = 0.045), tumours presenting with limb motor deficits (log-rank test p = 0.012), and tumours that underwent prior Simpson grade 3 or 4 excision (log-rank test p = 0.032). Conclusions: Meningiomas >10 cc in volume appear to display a high rate of progression and subsequent need for surgery following GKRS. Primary surgical resection, when not contraindicated, may be considered with GKRS serving an adjuvant role, especially in tumours exceeding 14 cc in volume, and presenting with limb motor deficits. Long-term clinical and radiological follow-up is essential following GKRS as the response of large meningiomas may be unpredictable.

show abstract

Section: Outcomes Of Gkrs In Meningioma and Factors Predicting Poor O...supporting

confidence: 79%

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc

Goyal-Honavar,

Pateriya,

Chauhan

et al. 2024

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

show abstract

“…Multiple studies have looked at the use of SRS in WHO grade 2 patients; however there are no prospective trials assessing this treatment modality. One study out of Northwestern University reviewed records of 97 patients with WHO grade 2 meningioma treated postoperatively with Gamma Knife radiosurgery from 1998–2014 [ 24 ]. Three- and 5-year actuarial local control rates were 68.9% and 55.7%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Trends in the use of radiation for meningioma across the United States

Matani

Abel

et al. 2022

Radiat Oncol J

View full text Add to dashboard Cite

Purpose: Meningiomas are tumors originating from arachnoid cap cells on the surface of the brain or spinal cord. Treatment differs by grade but can consist of observation, surgery, radiation therapy or both. We utilized the National Cancer Database (NCDB) to compare trends in the use stereotactic radiosurgery (SRS) and external beam radiation therapy (EBRT) in the management of meningioma. Materials and Methods: We queried the NCDB from 2004–2015 for meningioma patients (grade 1–3) treated with radiation therapy, either SRS or EBRT. Multivariable logistic regression was used to identify predictors of each treatment and to generate a propensity score. Propensity adjusted Kaplan-Meier survival curve analysis and multivariable Cox hazards ratios were used to identify predictors of survival. Results: We identified 5,406 patients with meningioma meeting above criteria with 45%, 44%, and 11% having World Health Organization (WHO) grade 1, 2, and 3 disease, respectively. Median follow up was 43 months. Predictors for SRS were grade 1 disease, distance from treatment facility, and histology. The only predictor of EBRT was grade 3 disease. Treatment year, histology, race and female sex were associated with improved survival. Five- and 10-year survival rates were 89.2% versus 72.6% (p < 0.0001) and 80.3% versus 61.4% (p = 0.29) for SRS and EBRT respectively. After propensity matching 226 pairs were generated. For SRS, 5-year survival was not significantly improved at 88.2% compared with EBRT (p = 0.056).Conclusion: In the present analysis, predictors of SRS utilization in management of meningioma include WHO grade 1 disease, distance from treatment facility and histology whereas conventional EBRT utilization was associated with grade 2 and 3 disease. Future studies need to be performed in order to optimize management of atypical and malignant meningioma.

show abstract

“…In another study, SRS was applied to 75 grade 2 meningioma cases due to postoperative residual or recurrence. [14] The 5-y OS was determined as 81.1% and the 5-y PFS as 55.7%. In our study, the 5-y PFS was found to be similar to this study with a rate of 57.7%, but no difference was found in terms of OS according to grade.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

DELİKGÖZ SOYKUT,

AKSAN,

ŞAVLI

et al. 2023

Journal of Contemporary Medicine

View full text Add to dashboard Cite

Aim: Innovations in radiotherapy have paved the way for alternative approaches for the treatment of meningioma, and in this context, radiosurgery has begun to be used in the treatment of meningioma. This study aimed to examine the clinical results of radiosurgery in the treatment of meningioma and to show whether it achieves the main goals, especially in terms of the possibility of tumor control and the success of preventing progression. Materials and Methods: Primary, residual, and recurrent meningioma treated with stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) between 2013 and 2020 were evaluated retrospectively. Study endpoints were overall survival (OS), progression free survival (PFS), and local control (LC). Results: 73 patients and 81 lesions were analyzed. The median duration of the follow-up period was 49 months (range, 7–138 months). 5- and 7-y OS and PFS were 87.6%, 78.9%; 82.9% and 82.9%, respectively. The tumor control rate was 94.6%. In univariate analysis, gender (p=0.007), radiosurgery for recurrence (p=0.011) and number of lesions (p=0.030) were found to be factors affecting OS, and number of lesions (p

show abstract

Gamma Knife Stereotactic Radiosurgery for Grade 2 Meningiomas

Cited by 15 publications

References 17 publications

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc

Trends in the use of radiation for meningioma across the United States

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

Contact Info

Product

Resources

About

Gamma Knife Stereotactic Radiosurgery for Grade 2 Meningiomas

Cited by 15 publications

References 17 publications

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas &gt;10 cc

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas &gt;10 cc

Trends in the use of radiation for meningioma across the United States

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

Contact Info

Product

Resources

About

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc

Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc