OBJECT: Increasingly, meningiomas are detected incidentally, prior to symptom development. While these lesions are traditionally managed conservatively until symptoms develop or lesion growth occurs, it is conceivable that patients at high risk for symptom development may benefit from earlier intervention prior to the appearance of symptoms. However, little research has been performed to determine whether Gamma Knife surgery (GKS) can alter the rate of symptom development in such patients. METHODS: A retrospective case study was performed by screening the University of Virginia GKS database for patients treated for asymptomatic meningiomas. From the patient's medical records, pertinent demographic and treatment information was obtained. Yearly follow-up MRI had been performed to assess tumor control and detect signs of radiation-induced injury. Clinical follow-up via neurological examination had been performed to assess symptom development. RESULTS: Forty-two patients, 33 females (78.6%) and 9 males (21.4%), with 42 asymptomatic meningiomas were included in the analysis. The median age at GKS was 53 years. The most common lesion location was the cerebral convexities (10 lesions [23.8%]), and the median lesion size was 4.0 ml. The median duration of imaging and clinical follow-ups was 59 and 76 months, respectively. During the follow-up period, 1 tumor (2.4%) increased in size, 2 patients (4.8%) demonstrated symptoms, and 1 patient (2.4%) exhibited possible signs of radiation-induced injury. Thus, actuarial tumor control rates were 100%, 95.7%, and 95.7% for 2, 5, and 10 years, respectively. Actuarial symptom control at 5 and 10 years was 97% and 93.1%, respectively. Overall progression-free survival was 91.1% and 77.8% at 5 and 10 years, respectively. CONCLUSIONS: Compared with published rates of symptom development in patients with untreated meningiomas, results in this study indicated that patients with asymptomatic lesions may benefit from prophylactic radiosurgery prior to the appearance of symptoms. Additionally, GKS is a treatment option that offers low morbidity.
OBJECT: Increasingly, meningiomas are detected incidentally, prior to symptom development. While these lesions are traditionally managed conservatively until symptoms develop or lesion growth occurs, it is conceivable that patients at high risk for symptom development may benefit from earlier intervention prior to the appearance of symptoms. However, little research has been performed to determine whether Gamma Knife surgery (GKS) can alter the rate of symptom development in such patients. METHODS: A retrospective case study was performed by screening the University of Virginia GKS database for patients treated for asymptomatic meningiomas. From the patient's medical records, pertinent demographic and treatment information was obtained. Yearly follow-up MRI had been performed to assess tumor control and detect signs of radiation-induced injury. Clinical follow-up via neurological examination had been performed to assess symptom development. RESULTS: Forty-two patients, 33 females (78.6%) and 9 males (21.4%), with 42 asymptomatic meningiomas were included in the analysis. The median age at GKS was 53 years. The most common lesion location was the cerebral convexities (10 lesions [23.8%]), and the median lesion size was 4.0 ml. The median duration of imaging and clinical follow-ups was 59 and 76 months, respectively. During the follow-up period, 1 tumor (2.4%) increased in size, 2 patients (4.8%) demonstrated symptoms, and 1 patient (2.4%) exhibited possible signs of radiation-induced injury. Thus, actuarial tumor control rates were 100%, 95.7%, and 95.7% for 2, 5, and 10 years, respectively. Actuarial symptom control at 5 and 10 years was 97% and 93.1%, respectively. Overall progression-free survival was 91.1% and 77.8% at 5 and 10 years, respectively. CONCLUSIONS: Compared with published rates of symptom development in patients with untreated meningiomas, results in this study indicated that patients with asymptomatic lesions may benefit from prophylactic radiosurgery prior to the appearance of symptoms. Additionally, GKS is a treatment option that offers low morbidity.
Authors: Henry Ruiz-Garcia; Daniel M Trifiletti; Nasser Mohammed; Yi-Chieh Hung; Zhiyuan Xu; Tomas Chytka; Roman Liscak; Manjul Tripathi; David Arsanious; Christopher P Cifarelli; Marco Perez Caceres; David Mathieu; Herwin Speckter; Gregory P Lekovic; Gautam U Mehta; Jason P Sheehan Journal: World Neurosurg Date: 2020-11-03 Impact factor: 2.104
Authors: Jason Sheehan; Stylianos Pikis; Abdurrahman I Islim; Ching-Jen Chen; Adomas Bunevicius; Selcuk Peker; Yavuz Samanci; Ahmed M Nabeel; Wael A Reda; Sameh R Tawadros; Amr M N El-Shehaby; Khaled Abdelkarim; Reem M Emad; Violaine Delabar; David Mathieu; Cheng-Chia Lee; Huai-Che Yang; Roman Liscak; Jaromir Hanuska; Roberto Martinez Alvarez; Dev Patel; Douglas Kondziolka; Nuria Martinez Moreno; Manjul Tripathi; Herwin Speckter; Camilo Albert; Greg N Bowden; Ronald J Benveniste; Lawrence Dade Lunsford; Michael D Jenkinson Journal: Neuro Oncol Date: 2022-01-05 Impact factor: 13.029
Authors: Yoon Jin Cha; Ji Hae Nahm; Ji Eun Ko; Hyun Joo Shin; Jong-Hee Chang; Nam Hoon Cho; Se Hoon Kim Journal: Yonsei Med J Date: 2015-11 Impact factor: 2.759