Surgical Resectability of Skull Base Meningiomas

Goto, Takeo; Ohata, Kenji

doi:10.2176/nmc.ra.2015-0354

Cited by 31 publications

(26 citation statements)

References 86 publications

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“…Overall, the anatomic constraints of the skull base limit GTR rates to 20 to 100% of cases, with complication rates from complete resection of 10 to 96%. 11,18,24,[29][30][31][32][33][34] These numbers may vary according to each specific region and improve according to the date of the published series. Currently, microsurgery embraces the concept of safe maximal resection, where the quality of life of the patients is prioritized.…”

Section: Resection For Neurofibromatosis Type-2 Associated Skull Basementioning

confidence: 99%

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Ruiz‐Garcia

Trifiletti

Mohammed

et al. 2021

J Neurol Surg B Skull Base

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Objective Meningiomas are the second most common tumors in neurofibromatosis type 2 (NF-2). Microsurgery is challenging in NF-2 patients presenting with skull base meningiomas due to the intrinsic risks and need for multiple interventions over time. We analyzed treatment outcomes and complications after primary Gamma Knife radiosurgery (GKRS) to delineate its role in the management of these tumors. Methods An international multicenter retrospective study approved by the International Radiosurgery Research Foundation was performed. NF-2 patients with at least one growing and/or symptomatic skull base meningioma and 6-month follow-up after primary GKRS were included. Clinical and radiosurgical parameters were recorded for analysis. Results In total, 22 NF-2 patients with 54 skull base meningiomas receiving GKRS as primary treatment met inclusion criteria. Median age at GKRS was 38 years (10–79 years). Most lesions were located in the posterior fossa (55.6%). Actuarial progression free survival (PFS) rates were 98.1% at 2 years and 90.0% at 5 and 10 years. The median follow-up time after initial GKRS was 5.0 years (0.6–25.5 years). Tumor volume at GKRS was a predictor of tumor control. Lesions >5.5 cc presented higher chances to progress after radiosurgery (p = 0.043). Three patients (13.64%) developed adverse radiation effects. No malignant transformation or death due to meningioma or radiosurgery was reported. Conclusions GKRS is effective and safe in the management of skull base meningiomas in NF-2 patients. Tumor volume deserve greater relevance during clinical decision-making regarding the most appropriate time to treat. GKRS offers a minimally invasive approach of particular interest in this specific group of patients.

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Section: Resection For Neurofibromatosis Type-2 Associated Skull Basementioning

confidence: 99%

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Ruiz‐Garcia

Trifiletti

Mohammed

et al. 2021

J Neurol Surg B Skull Base

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“…Favorable treatment results for brain tumors, for example, meningioma have been obtained using SRS/ SRT. 4,[8][9][10][11][12][13][14][15] The dedicated machines designed for effective SRS and SRT include Gammaknife, conventional linear accelerator, and Cyber-Knife, which is a compact, image-guided linear accelerator with a robotic manipulator.…”

Section: Introductionmentioning

confidence: 99%

Knowledge‐based planning in robotic intracranial stereotactic radiosurgery treatments

Zhang

et al. 2021

J Applied Clin Med Phys

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Purpose: To develop a knowledge-based planning (KBP) model that predicts dosimetric indices and facilitates planning in CyberKnife intracranial stereotactic radiosurgery/radiotherapy (SRS/SRT). Methods: Forty CyberKnife SRS/SRT plans were retrospectively used to build a linear KBP model which correlated the equivalent radius of the PTV (r eq_PTV) and the equivalent radius of volume that receives a set of prescription dose (r eq_Vi , where V i = V 10% , V 20%. .. V 120%). To evaluate the model's predictability, a fourfold crossvalidation was performed for dosimetric indices such as gradient measure (GM) and brain V 50%. The accuracy of the prediction was quantified by the mean and the standard deviation of the difference between planned and predicted values, (i.e., GM = GM pred − GM clin and fractional V 50% = (V 50%pred − V 50%clin)/V 50%clin) and a coefficient of determination, R 2. Then, the KBP model was incorporated into the planning for another 22 clinical cases. The training plans and the KBP test plans were compared in terms of the new conformity index (nCI) as well as the planning efficiency. Results: Our KBP model showed desirable predictability. For the 40 training plans, the average prediction error from cross-validation was only 0.36 AE 0.06 mm for GM, and 0.12 AE 0.08 for V 50%. The R 2 for the linear fit between r eq_PTV and r eq_vi was 0.985 AE 0.019 for isodose volumes ranging from V 10% to V 120% ; particularly, R 2 = 0.995 for V 50% and R 2 = 0.997 for V 100%. Compared to the training plans, our KBP test plan nCI was improved from 1.31 AE 0.15 to 1.15 AE 0.08 (P < 0.0001). The efficient automatic generation of the optimization constraints by using our model requested no or little planner's intervention. Conclusion: We demonstrated a linear KBP based on PTV volumes that accurately predicts CyberKnife SRS/SRT planning dosimetric indices and greatly helps achieve superior plan quality and planning efficiency.

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“…The term "invasive meningioma" has usually been linked to high-grade meningiomas, aiming at the brain parenchymal infiltration by the tumor cells [14,29]. Regarding skull base invasive meningiomas, the significant scientific work was conducted to study the surgical and radiotherapeutic strategies [15,19,37,42]. A little effort was made to study the biological background of Skull Base Invasive Low-grade Meningioma (SBILM).…”

Section: Introductionmentioning

confidence: 99%

Skull base invasive low-grade meningiomas, a distinct genetic subgroup: A microarray gene expression profile analysis

Sakuma

Fujii

Kishida

et al. 2018

Preprint

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Surgical Resectability of Skull Base Meningiomas

Cited by 31 publications

References 86 publications

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Skull Base Meningiomas in Patients with Neurofibromatosis Type 2: An International Multicenter Study Evaluating Stereotactic Radiosurgery

Knowledge‐based planning in robotic intracranial stereotactic radiosurgery treatments

Skull base invasive low-grade meningiomas, a distinct genetic subgroup: A microarray gene expression profile analysis

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