BACKGROUND: Peritumoral edema is a recognized complication following stereotactic radiosurgery (SRS). OBJECTIVE: To evaluate the risk of posttreatment peritumoral edema following SRS for intracranial meningiomas and determine predictive factors. METHODS: Between 2002 and 2008, 173 evaluable patients underwent CyberKnife or Gamma Knife SRS for meningiomas. Eighty-four patients (49%) had prior surgical resections, 13 patients had World Health Organization grade II (atypical) meningiomas, and 117 patients had a neurological deficit before SRS. Sixty-two tumors were in parasagittal, parafalcine, and convexity locations. The median tumor volume was 4.7 mL (range, 0.1-231.8 mL). The median prescribed dose and median prescribed biologically equivalent dose were 15 Gy (range, 9-40 Gy) and 67 Gy (range, 14-116 Gy), respectively. Ninety-seven patients were treated with single-fraction SRS, 74 received 2 to 5 fractions, and 2 received >5 fractions. RESULTS: The median follow-up was 21.0 months. Thirteen patients (8%) developed symptomatic peritumoral edema, with a median onset time of 4.5 months (range, 0.2-9.5 months). The 3-, 6-, 12-, and 24-month actuarial symptomatic edema rates were 2.9%, 4.9%, 7.7%, and 8.5%, respectively. The crude tumor control rate was 94%. On univariate analysis, large tumor volume (P = .01) and single-fraction SRS (P = .04) were predictive for development of posttreatment edema. CONCLUSION: SRS meningioma treatment demonstrated a low incidence of toxicity; however, large tumor volumes and single-fraction SRS treatment had an increased risk for posttreatment edema. Risk factors for edema should be considered in meningiomas treatment.
BACKGROUND: Peritumoral edema is a recognized complication following stereotactic radiosurgery (SRS). OBJECTIVE: To evaluate the risk of posttreatment peritumoral edema following SRS for intracranial meningiomas and determine predictive factors. METHODS: Between 2002 and 2008, 173 evaluable patients underwent CyberKnife or Gamma Knife SRS for meningiomas. Eighty-four patients (49%) had prior surgical resections, 13 patients had World Health Organization grade II (atypical) meningiomas, and 117 patients had a neurological deficit before SRS. Sixty-two tumors were in parasagittal, parafalcine, and convexity locations. The median tumor volume was 4.7 mL (range, 0.1-231.8 mL). The median prescribed dose and median prescribed biologically equivalent dose were 15 Gy (range, 9-40 Gy) and 67 Gy (range, 14-116 Gy), respectively. Ninety-seven patients were treated with single-fraction SRS, 74 received 2 to 5 fractions, and 2 received >5 fractions. RESULTS: The median follow-up was 21.0 months. Thirteen patients (8%) developed symptomatic peritumoral edema, with a median onset time of 4.5 months (range, 0.2-9.5 months). The 3-, 6-, 12-, and 24-month actuarial symptomatic edema rates were 2.9%, 4.9%, 7.7%, and 8.5%, respectively. The crude tumor control rate was 94%. On univariate analysis, large tumor volume (P = .01) and single-fraction SRS (P = .04) were predictive for development of posttreatment edema. CONCLUSION:SRS meningioma treatment demonstrated a low incidence of toxicity; however, large tumor volumes and single-fraction SRS treatment had an increased risk for posttreatment edema. Risk factors for edema should be considered in meningiomas treatment.
Authors: Leland Rogers; Igor Barani; Marc Chamberlain; Thomas J Kaley; Michael McDermott; Jeffrey Raizer; David Schiff; Damien C Weber; Patrick Y Wen; Michael A Vogelbaum Journal: J Neurosurg Date: 2015-01 Impact factor: 5.115
Authors: Emory McTyre; Corbin A Helis; Michael Farris; Lisa Wilkins; Darrell Sloan; William H Hinson; J Daniel Bourland; William A Dezarn; Michael T Munley; Kounosuke Watabe; Fei Xing; Adrian W Laxton; Stephen B Tatter; Michael D Chan Journal: Neurosurgery Date: 2017-02-01 Impact factor: 4.654
Authors: Jason P Sheehan; Or Cohen-Inbar; Rawee Ruangkanchanasetr; S Bulent Omay; Judith Hess; Veronica Chiang; Christian Iorio-Morin; Michelle Alonso-Basanta; David Mathieu; Inga S Grills; John Y K Lee; Cheng-Chia Lee; L Dade Lunsford Journal: J Neurooncol Date: 2015-09-02 Impact factor: 4.130
Authors: Roberto Stefini; Stefano Peron; Alessandro Lacamera; Andrea Cividini; Pietro Fiaschi; Giovanni Marco Sicuri Journal: Surg Neurol Int Date: 2021-07-19