Radiation Therapy in the Treatment of Partially Resected Meningiomas

Barbaro, Nicholas M.; Gutin, Philip H.; Wilson, Charles B.; Sheline, Glenn E.; Boldrey, Edwin; Wara, William M.

doi:10.1227/00006123-198704000-00003

Cited by 298 publications

(68 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Histological examination revealed the presence of tumor cells in the cyst wall adjacent to the solid tumor. Previous reports provide evidence that radiation therapy is beneficial in the treatment of residual meningiomas 3,11) or meningiomas of the skull base. 23) Radiotherapy for atypical or malignant meningioma is recommended immediately after initial surgery.…”

Section: Discussionmentioning

confidence: 99%

Atypical Meningioma With Large Cyst-Case Report-

Senbokuya

Asahara

Uchida

et al. 2006

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 29-year-old male presented with loss of consciousness and generalized seizure, followed by right hemiparesis and speech disturbance. Computed tomography and magnetic resonance imaging showed a solid, enhanced tumor with a cyst in the left frontal area with surrounding edema and mild mass effect. The cyst wall was also enhanced. The preoperative diagnosis was cystic falx meningioma. The tumor was totally resected, but most of the cyst wall adhered tightly to the surrounding brain and could not be removed. Histological examination revealed atypical meningioma and tumor cells in the cyst wall. The patient received local radiotherapy to the residual cyst wall with a total dose of 50 Gy.

show abstract

Section: Discussionmentioning

confidence: 99%

Atypical Meningioma With Large Cyst-Case Report-

Senbokuya

Asahara

Uchida

et al. 2006

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…[28][29][30] As more conformal therapies were developed, higher radiation doses could be administered while sparing dose to surrounding neural structures, resulting in an additional…”

Section: Radiosurgical Treatmentmentioning

confidence: 99%

“…[28][29][30] As more conformal therapies were developed, higher radiation doses could be administered while sparing dose to surrounding neural structures, resulting in an additional improvement in the 10-year progression-free survival rate. In a more recent study, Mendenhall et al 31 have shown five-, 10-, and 15-year local control rates of 95, 92, and 92%, respectively, for meningiomas treated with radiation therapy subsequent to subtotal resection.…”

Section: Radiosurgical Treatmentmentioning

confidence: 99%

Surgical and Radiation Treatment of Skull Base Meningiomas

Cole¹,

Couldwell²

2008

US Neurology

View full text Add to dashboard Cite

Meningiomas comprise approximately 20% of adult primary intracranial neoplasms.1 Of these, benign meningiomas are known to have an indolent growth pattern, usually without infiltration into adjacent nervous tissue. [2][3][4][5] Because meningiomas have a well-circumscribed character, surgery has historically been the preferred treatment when total resection can be achieved with reasonable morbidity. Surgical resection has resulted in five-, 10-, and 15-year progression-free rates of 93, 80, and 68%, respectively. 6 Despite the development of multiple techniques designed to minimize morbidity while obtaining a surgical cure, however, complete resection remains difficult and is not achievable in approximately 20-30% of presenting patients because of multiple regional involvement, severe adherence to or invasion of the brainstem, involvement of cranial nerves, or encasement of the vertebrobasilar circulation. 6-11 Currently, controversy exists as to whether skull base meningiomas, especially those involving the petroclivus and/or cavernous sinus, are best treated with radical resection, subtotal resection followed by radiosurgical treatment of the residual lesion, or radiosurgical treatment alone. Petroclival Tumors and Cavernous ExtensionMeningiomas of the petroclival region usually involve the petrous apex and the upper two-thirds of the clivus. Appropriately, cautious subtotal resection has become the preferred treatment to reduce post-operative morbidity, along with the addition of radiation treatment of tumor remnants. 18-21Meningiomas along the medial sphenoid wing that invade the cavernous sinus are also a treatment challenge because of the possibility of tumor infiltration of the traversing cranial nerves and internal carotid artery and, to a lesser degree, the involvement of the adjacent pituitary gland. 22 The goal of surgical cure must therefore take into account local invasion of neurovascular structures within the cavernous sinus. As a consequence, several authors have emphasized the use of subtotal resection to limit the risk for permanent post-operative cranial nerve or the potential for vascular injury over complete resection. 7,9,12,23 The long-term outcome after subtotal resection of meningiomas within the cavernous sinus alone is, however, associated with an unacceptably high symptomatic recurrence rate. 24 Radiosurgical TreatmentDespite the high symptomatic recurrence rate and microsurgical improvements over the past few years, subtotal resection of meningiomas along the skull base, particularly those within the petroclival and cavernous sinus locations, remains a desired surgical outcome because such limited resection lends an acceptable level of morbidity. 7,11,[25][26][27] Because of the unacceptable morbidity of radical resection, along with the high incidence of recurrence, adjuvant techniques for treating these tumors have been developed.Early studies from the 1980s demonstrated that external-beam field radiation therapy could provide durable local tumor control for those benign meningio...

show abstract

“…One of these studies found that the risk for developing clinically detectable residuals following a subtotal tumor resection was halved following postoperative radiotherapy (35). Another study found that postoperative radiotherapy following subtotal meningioma resection reduced the recurrence risk from approximately 80% to approximately lo'% during a ten-year period, and that even patients who were reoperated after previous surgery for meningioma benefited clinically from radiotherapy.…”

Section: Meningiornamentioning

confidence: 99%