Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas

Lee, John Y.K.; Niranjan, Ajay; McInerney, James; Kondziolka, Douglas; Flíckinger, John C.; Lunsford, L. Dade

doi:10.3171/jns.2002.97.1.0065

Cited by 376 publications

(196 citation statements)

References 41 publications

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“…After 1 year and 5 years, the rate for radiation-related complications were 6% and 11%, respectively. Other authors reported comparable results [11,12,32]. SRS is therefore commonly used for small lesions ( < 3 cm) while larger lesions, and lesions with a close proximity to the brain stem or other organs at risk, are treated by fractionated stereotactic radiotherapy.…”

Section: Skull Base Tumorssupporting

confidence: 49%

Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for neurooncological and neurological diseases: state of the art and future perspectives

Münter

Welker

Jensen

et al. 2013

Innovative Neurosurgery

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Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) are well established in a high number of neurooncological and neurological lesions. Modern technologies discussed in this review, especially the integration of multimodality imaging in the daily clinical routine, will further improve the results of SRS and SRT. Currently, the different technical methods used are comparable regarding the clinical results in different clinical indications. The technological advances allow high treatment flexibility, and therefore, new treatment indications can be established based on the new technologies. In the future, it has to be defined more clearly whether a single fraction, hypofractionated concepts, or fractionated stereotactic radiotherapy is more effective regarding the clinical results and side effects of the therapy. The main area of development for radiosurgery will be stereotactic body radiosurgery. More randomized clinical studies for all possible indications are needed in the next few decades in order to establish radiosurgery more precisely, and also to determine its true value, especially in normal-fractionated radiotherapy. In technological development, the next step has been completed and proton or particle based stereotactic radiosurgery may have increased use in the future.

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Section: Skull Base Tumorssupporting

confidence: 49%

Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for neurooncological and neurological diseases: state of the art and future perspectives

Münter

Welker

Jensen

et al. 2013

Innovative Neurosurgery

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“…Actual tumor growth control rate after GMK of CS meningiomas ranged from 91% to 96.5% at 5 years and 82% to 94% at 10 years (10,12,13,16,23,24,35). In our series, 85.7% patients (12 out of 14 patients) after GMK treatment did not regrow for a mean follow up of 90.6 months and 2 patients had related acceptable complications, including 1 patient had visual deterioration and 1 face hypesthesia on the side of tumor after GMK.…”

Section: Radiosurgerymentioning

confidence: 81%

Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases

Liu

Yuan²,

Liu³

et al. 2012

Turkish Neurosurgery

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AIm:We present the long-term outcomes as well as their correlation with tumor size in 127 consecutive patients harboring large MSWM after microsurgical treatment. mATeRIAL and meTHods:The retrospective analysis of clinical data and follow-up data of 127 microsurgical treated patients with MSWM was performed. The mean maximum diameter of tumors was 5.2cm (ranged 1.5-10.0cm).ResuLTs: 104 cases (81.9%) achieved gross total resection. There was no operative mortality. Detailed follow-up data was available in 120 cases for a mean duration of 81.6 months (12-216 months). The permanent morbidity was 14.2%. The mean KPS score 1 year after surgery was 90.6 (ranged 60-100). Among 74 patients of preoperative visual acuity (VA) impairment, postoperative VA improved in 42 cases (56.8%), unchanged in 30 (40.5%), and deteriorated in 2 (2.7%). MR images revealed tumor recurrence after total resection in 10 cases (10.2%) and tumor progression after subtotal resection in 10 cases (45.5%).CoNCLusIoN: Tumor recurrence was the major risk in the long run, thus the initial surgery was extremely important and hence should be aggressive. The size of tumor affected the extent of tumor removal determining clinical outcomes including VA improvement and KPS score immediately after surgery; however, it was not correlated with long-term overall outcomes. BuLGuLAR: 104 olguda (%81,9) gros total rezeksiyon yapıldı. Operatif mortalite yoktu. Ayrıntılı takip verileri 120 olguda ortalama 81,6 ay (12-216 ay) için mevcuttu. Kalıcı morbidite %14,2 oranında görüldü. Cerrahiden 1 yıl sonra ortalama KPS skoru 90,6 (aralık 60-100) bulundu. Preoperatif görme keskinliği bozukluğu olan 74 hasta içinde postoperatif dönemde görme keskinliği 42 hastada (%56,8) arttı, 30'unda (%40,5) değişmedi ve 2'sinde (%2,7) kötüye gitti. MR görüntüleri total rezeksiyon sonrasında 10 olguda (%10,2) tümör reküransı ve subtotal rezeksiyon sonrasında 10 olguda (%45,5) tümör ilerlemesi gösterdi. soNuÇ: Uzun dönemde temel risk tümör reküransıydı ve bu nedenle ilk cerrahi çok önemlidir ve agresif olmalıdır. Tümör büyüklüğü, tümör çıkarma kapsamını etkileyerek ameliyattan hemen sonra görme keskinliği düzelmesi ve KPS skoru dahil klinik sonuçları etkiledi ancak uzun dönemli genel sonuçlarla korelasyon göstermedi.ANAHTAR sÖZCÜKLeR: Medial sfenoid kanat menenjiyomları, Tümör büyüklüğü, Tümör reküransı, İşlevsel sonuç

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“…If the tumour is densely adherent to vital blood vessels, nerves or the brainstem and hard to resect completely, it is considered optimal to leave a small margin of tumour behind and implement postoperative adjuvant radiotherapy or γ-knife therapy to control tumour recurrence effectively. 21,22 The primary objective in resecting posterior petrous meningiomas is to remove the tumour base to stop the blood supply and reduce haemorrhage. Sometimes, because of the large size of these tumours and the complicated associations that they make with the surrounding anatomical structures, it is not easy to separate the tumour base until internal decompression has been performed repeatedly and the tumour resected little by little.…”

Section: Discussionmentioning

confidence: 99%

The Classification of Posterior Petrous Meningiomas and Its Clinical Significance

Zhou

Wang

et al. 2009

J Int Med Res

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This retrospective analysis of the clinical records of 42 patients was used to study the clinical significance of a classification system for posterior petrous meningiomas. According to clinical manifestations and radiological images, posterior petrous meningiomas were classified into three types: type I (cerebella type; 12 patients), tumours involved and compressed the cerebellum; type II (cranial nerve type; 16 patients), tumours involved the cranial nerves; and type III (combined type; 14 patients), tumours involved more than one structure such as the cerebellum, cranial nerves and the brain stem. All patients underwent microneurosurgery and the total resection rate was 90%. It was more difficult totally to resect type II and III tumours than type I tumours and the post-operative functional outcomes were worse. Microneurosurgical techniques and skills are critical to increase the total resection rate of posterior petrous meningiomas in order to decrease the mortality and disability rates.

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Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas

Abstract: Stereotactic radiosurgery provided safe and effective management of cavernous sinus meningiomas. We believe it is the preferred management strategy for tumors of suitable volume (average tumor diameter < or = 3 cm or volume < or = 15 cm3).

Cited by 376 publications

References 41 publications

Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for neurooncological and neurological diseases: state of the art and future perspectives

Stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for neurooncological and neurological diseases: state of the art and future perspectives

Large medial sphenoid wing meningiomas: long-term outcome and correlation with tumor size after microsurgical treatment in 127 consecutive cases

The Classification of Posterior Petrous Meningiomas and Its Clinical Significance

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