Mustafa El-Khatib1,2, Faycal El Majdoub3,4, Stefan Hunsche5,6, Mauritius Hoevels7, Martin Kocher8, Volker Sturm9,10, Mohammad Maarouf11,12. 1. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. mustafa.el-khatib@ukb.uni-bonn.de. 2. Department of Neurosurgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany. mustafa.el-khatib@ukb.uni-bonn.de. 3. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. elmajdoubf@kliniken-koeln.de. 4. Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany. elmajdoubf@kliniken-koeln.de. 5. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. hunsches@kliniken-koeln.de. 6. Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany. hunsches@kliniken-koeln.de. 7. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. mauritius.hoevels@uk-koeln.de. 8. Department of Radiation Oncology, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. martin.kocher@uk-koeln.de. 9. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. volkersturm@online.de. 10. Department of Neurosurgery, University Hospital of Wurzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany. volkersturm@online.de. 11. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50938, Cologne, Germany. maaroufm@kliniken-koeln.de. 12. Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany. maaroufm@kliniken-koeln.de.
Abstract
PURPOSE: The efficacy and safety of stereotactic radiosurgery (SRS) for treatment of intracranial meningiomas has been demonstrated in numerous studies with short- and intermediate-term follow-up. In this retrospective single-center study, we present long-term outcomes of SRS performed with a linear accelerator (LINAC) for typical intracranial meningiomas. PATIENTS AND METHODS: Between August 1990 and December 2007, 148 patients with 168 typical intracranial meningiomas were treated with stereotactic LINAC-SRS, either as primary treatment or after microsurgical resection. A median tumor surface dose of 12 Gy (range 7-20 Gy) and a median maximum dose of 24.1 Gy (range 11.3-58.6 Gy) was applied. The median target volume was 4.7 ml (range 0.2-32.8 ml, SD ± 4.8 ml). RESULTS: Overall mean radiological follow-up was 12.6 years. Tumor shrinkage was seen in 75 (44.6 %) and stable disease in 85 (50.6 %) cases. Eight of 168 meningiomas (4.8 %) showed local tumor progression. The tumor control rate (TCR) after 5, 10, and 15 years was 93.6 % at each time point, and the progression-free survival (PSF) rates were 92, 89, and 89 %, respectively. The neurological symptoms existing prior to LINAC-SRS improved in 77 patients (59.7 %), remained unchanged in 42 (32.6 %), and deteriorated in 10 (7.8 %) patients. CONCLUSION: Our study emphasizes the efficacy of LINAC-SRS for de novo, residual and recurrent typical intracranial meningiomas. A high long-term local TCR with a low morbidity rate could be achieved. LINAC-SRS should thus be considered as a primary treatment option, as one arm of a combined treatment approach for incompletely resected meningiomas, or as a salvage therapy for recurrences.
PURPOSE: The efficacy and safety of stereotactic radiosurgery (SRS) for treatment of intracranial meningiomas has been demonstrated in numerous studies with short- and intermediate-term follow-up. In this retrospective single-center study, we present long-term outcomes of SRS performed with a linear accelerator (LINAC) for typical intracranial meningiomas. PATIENTS AND METHODS: Between August 1990 and December 2007, 148 patients with 168 typical intracranial meningiomas were treated with stereotactic LINAC-SRS, either as primary treatment or after microsurgical resection. A median tumor surface dose of 12 Gy (range 7-20 Gy) and a median maximum dose of 24.1 Gy (range 11.3-58.6 Gy) was applied. The median target volume was 4.7 ml (range 0.2-32.8 ml, SD ± 4.8 ml). RESULTS: Overall mean radiological follow-up was 12.6 years. Tumor shrinkage was seen in 75 (44.6 %) and stable disease in 85 (50.6 %) cases. Eight of 168 meningiomas (4.8 %) showed local tumor progression. The tumor control rate (TCR) after 5, 10, and 15 years was 93.6 % at each time point, and the progression-free survival (PSF) rates were 92, 89, and 89 %, respectively. The neurological symptoms existing prior to LINAC-SRS improved in 77 patients (59.7 %), remained unchanged in 42 (32.6 %), and deteriorated in 10 (7.8 %) patients. CONCLUSION: Our study emphasizes the efficacy of LINAC-SRS for de novo, residual and recurrent typical intracranial meningiomas. A high long-term local TCR with a low morbidity rate could be achieved. LINAC-SRS should thus be considered as a primary treatment option, as one arm of a combined treatment approach for incompletely resected meningiomas, or as a salvage therapy for recurrences.
Authors: C Nutting; M Brada; L Brazil; A Sibtain; F Saran; C Westbury; A Moore; D G Thomas; D Traish; S Ashley Journal: J Neurosurg Date: 1999-05 Impact factor: 5.115
Authors: P H Roche; J Régis; H Dufour; H D Fournier; C Delsanti; W Pellet; F Grisoli; J C Peragut Journal: J Neurosurg Date: 2000-12 Impact factor: 5.115
Authors: Sara Alatriste-Martínez; Sergio Moreno-Jiménez; Guillermo A Gutiérrez-Aceves; José de Jesús Suárez-Campos; Olivia Amanda García-Garduño; Alejandro Rosas-Cabral; Miguel Ángel Celis-López Journal: World Neurosurg X Date: 2019-03-07
Authors: Marcello Marchetti; Arjun Sahgal; Antonio A F De Salles; Marc Levivier; Lijun Ma; Ian Paddick; Bruce E Pollock; Jean Regis; Jason Sheehan; John H Suh; Shoji Yomo; Laura Fariselli Journal: Neurosurgery Date: 2020-10-15 Impact factor: 4.654