OBJECT: Stereotactic radiosurgery (SRS) has been shown to offer a high probability of tumor control for Grade I meningiomas. However, SRS can sometimes incite edema or exacerbate preexisting edema around the targeted meningioma. The current study evaluates the incidence, timing, and degree of edema around parasagittal or parafalcine meningiomas following SRS. METHODS: A retrospective review was undertaken of a prospectively maintained database of patients treated with Gamma Knife radiosurgery at the University of Virginia Health System. All patients with WHO Grade I parafalcine or parasagittal meningiomas with at least 6 months of clinical follow-up were identified, resulting in 61 patients included in the study. The median radiographic follow-up was 28 months (range 6-158 months). Rates of new or worsening edema were quantitatively assessed using volumetric analysis; edema indices were computed as a function of time following radiosurgery. Statistical methods were used to identify favorable and unfavorable prognostic factors for new or worsening edema. RESULTS: Progression-free survival at 2 and 5 years was 98% and 90%, respectively, according to Kaplan-Meier analysis. After SRS, new peritumoral edema occurred or preexisting edema worsened in 40% of treated meningiomas. The median time to onset of peak edema was 36 months post-SRS. Persistent and progressive edema was associated with 11 tumors, and resection was undertaken for these lesions. However, 20 patients showed initial edema progression followed by regression at a median of 18 months after radiosurgery (range 6-24 months). Initial tumor volume greater than 10 cm3, absence of prior resection, and higher margin dose were significantly (p<0.05) associated with increased risk of new or progressive edema after SRS. CONCLUSIONS: Stereotactic radiosurgery offers a high rate of tumor control in patients with parasagittal or parafalcine meningiomas. However, it can lead to worsening peritumoral edema in a minority of patients. Following radiosurgery, transient edema occurs earlier than persistent and progressive edema. Longitudinal follow-up of meningioma patients after SRS is required to detect and appropriately treat transient as well as progressive edema.
OBJECT: Stereotactic radiosurgery (SRS) has been shown to offer a high probability of tumor control for Grade I meningiomas. However, SRS can sometimes incite edema or exacerbate preexisting edema around the targeted meningioma. The current study evaluates the incidence, timing, and degree of edema around parasagittal or parafalcine meningiomas following SRS. METHODS: A retrospective review was undertaken of a prospectively maintained database of patients treated with Gamma Knife radiosurgery at the University of Virginia Health System. All patients with WHO Grade I parafalcine or parasagittal meningiomas with at least 6 months of clinical follow-up were identified, resulting in 61 patients included in the study. The median radiographic follow-up was 28 months (range 6-158 months). Rates of new or worsening edema were quantitatively assessed using volumetric analysis; edema indices were computed as a function of time following radiosurgery. Statistical methods were used to identify favorable and unfavorable prognostic factors for new or worsening edema. RESULTS: Progression-free survival at 2 and 5 years was 98% and 90%, respectively, according to Kaplan-Meier analysis. After SRS, new peritumoral edema occurred or preexisting edema worsened in 40% of treated meningiomas. The median time to onset of peak edema was 36 months post-SRS. Persistent and progressive edema was associated with 11 tumors, and resection was undertaken for these lesions. However, 20 patients showed initial edema progression followed by regression at a median of 18 months after radiosurgery (range 6-24 months). Initial tumor volume greater than 10 cm3, absence of prior resection, and higher margin dose were significantly (p<0.05) associated with increased risk of new or progressive edema after SRS. CONCLUSIONS: Stereotactic radiosurgery offers a high rate of tumor control in patients with parasagittal or parafalcine meningiomas. However, it can lead to worsening peritumoral edema in a minority of patients. Following radiosurgery, transient edema occurs earlier than persistent and progressive edema. Longitudinal follow-up of meningiomapatients after SRS is required to detect and appropriately treat transient as well as progressive edema.
Authors: Georgios Mantziaris; Stylianos Pikis; Yavuz Samanci; Selcuk Peker; 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; Nuria Martinez Moreno; Manjul Tripathi; Herwin Speckter; Camilo Albert; Ronald J Benveniste; Greg N Bowden; Dev N Patel; Douglas Kondziolka; Kenneth Bernstein; L Dade Lunsford; Michael D Jenkinson; Abdurrahman I Islim; Jason Sheehan Journal: J Neurooncol Date: 2022-01-24 Impact factor: 4.130
Authors: In-Ho Jung; Kyung Won Chang; So Hee Park; Hyun Ho Jung; Jong Hee Chang; Jin Woo Chang; Won Seok Chang Journal: Sci Rep Date: 2022-08-11 Impact factor: 4.996
Authors: Kathryn R Fega; Geoffrey P Fletcher; Mark R Waddle; Jennifer L Peterson; Jonathan B Ashman; David M Barrs; Bernard R Bendok; Naresh P Patel; Alyx B Porter; Sujay A Vora Journal: Adv Radiat Oncol Date: 2018-08-23
Authors: Roberto Stefini; Stefano Peron; Alessandro Lacamera; Andrea Cividini; Pietro Fiaschi; Giovanni Marco Sicuri Journal: Surg Neurol Int Date: 2021-07-19