Role of brachytherapy in the management of the skull base meningioma treatment of skull base meningiomas

Abstract

Background. The treatment of primary and recurrent skull base meningiomas presents a formidable surgical problem. Methods. Fifteen patients with primary and recurrent skull base meningiomas were treated by means of interstitial irradiation with iodine 125 (125I) seed implantation. The physical characteristics of 125I enabled the authors to administer a minimum tumor dose ranging from 100 to 500 Gy at a low dose rate of 0.05–0.25 Gy per hour. Results. All 15 patients are alive at a median follow‐up of 29 months. Of the 15 patients, 2 with calcification and 2 without calcification achieved only partial responses. The remaining 11 patients achieved a complete response. No early or late complications were observed. Conclusions. From these data, the authors conclude that interstitial irradiation with 125I seeds is an effective, safe, and simple method in the treatment of both recurrent and primary skull base meningiomas.

Nonvestibular Schwannoma Tumors in the Cerebellopontine Angle: A Structured Approach and Management Guidelines

“…11,15 Similarly, brachytherapy with iodine 125 seems to be of value for both recurrent and primary skull base meningiomas. 16…”

Role of Perioperative Brachytherapy in the Treatment of Malignancies Involving the Skull Base and Orbit

“…The Nebraska group 9,17,26,27 seems to have the greatest experience with Iodine-125 seed implantation for the sole interstitial BT of skull base tumors. They predominantly treated, however, benign skull base tumors and malignant skull base primaries in the minority of their cases only.…”

Gamma Knife Radiosurgery for Meningiomas of the Convexity and Cavernous Sinus

“…Other therapies have been reported for these recalcitrant meningiomas 44 Castro et al 45 reported an 85% 5-year local control rate for a series of 223 tumors of the skull base treated with charged particle radiation. Kumar et al 46 described their use of brachytherapy for skull base tumors using 125 I seeds for their low dose rate. Mini-mum tumor doses of 100 to 500 Gy were delivered to the tumors and the seeds were placed directly in 2 of 15 patients and placed stereotactically in the remainder.…”