Factors Influencing Long-Term Outcomes of Single-Session Gamma Knife Radiosurgery in Large-Volume Meningiomas >10 cc

被引:0
作者
Goyal-Honavar, Abhijit [1 ]
Pateriya, Vibhor [1 ]
Chauhan, Sonal [1 ]
Sadashiva, Nishanth [1 ]
Vazhayil, Vikas [1 ]
Konar, Subhas [1 ]
Beniwal, Manish [1 ]
Ar, Prabhuraj [1 ]
Arimappamagan, Arivazhagan [1 ]
Jeeva, B.
Natesan, Ponnusamy [1 ]
机构
[1] Natl Inst Mental Hlth & Neurosci NIMHANS, Dept Neurosurg, Bengaluru, India
关键词
Gamma knife radiosurgery; Radiosurgery; Meningiomas; Progression-free survival; Peritumoural oedema; STEREOTACTIC RADIOSURGERY; INTRACRANIAL MENINGIOMAS; PARAFALCINE MENINGIOMAS; FOLLOW-UP; SURGERY; EDEMA;
D O I
10.1159/000536409
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Introduction: Meningiomas are the most common primary intracranial tumour. Gamma knife radiosurgery (GKRS) is a frequently employed non-invasive method of treatment, with good remission rates and low morbidity in literature. However, the role of GKRS in the management of "large" meningiomas is unclear, with reported outcomes that vary by centre. We aimed to assess the factors that influence long-term outcomes following GKRS in meningiomas >10 cc in volume. Methods: A retrospectively analysed all patients with meningiomas exceeding 10 cc in volume who underwent GKRS between January 2006 and December 2021 at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. Demographic, clinical, radiological, and follow-up data were acquired, and factors associated with progression following GKRS were assessed. Results: The cohort comprised 76 patients 29 males (38.2%) and 47 females (61.8%) with a mean age of 46.3 +/- 11.02 years. Thirty-nine patients had been previously operated (51.3%). Meningiomas were most frequently located in the parasagittal region (26 tumours, 34.2%) and sphenopetroclival region (23 tumours, 30.3%), with mean lesion volume of 12.55 +/- 5.22 cc, ranging 10.3 cc-25 cc. The mean dose administered to the tumour margin was 12.5 Gy +/- 1.2 Gy (range 6-15 Gy). The median duration of clinical follow-up was 48 months, over which period radiological progression occurred in 14 cases (20%), with unchanged tumour volume in 20 cases (28.6%) and reduction in size of the tumour in 36 cases (51.4%). Progression-free survival after GKRS was 72% at 5 years, was significantly poorer among meningiomas with tumour volume >14 cc (log-rank test p = 0.045), tumours presenting with limb motor deficits (log-rank test p = 0.012), and tumours that underwent prior Simpson grade 3 or 4 excision (log-rank test p = 0.032). Conclusions: Meningiomas >10 cc in volume appear to display a high rate of progression and subsequent need for surgery following GKRS. Primary surgical resection, when not contraindicated, may be considered with GKRS serving an adjuvant role, especially in tumours exceeding 14 cc in volume, and presenting with limb motor deficits. Long-term clinical and radiological follow-up is essential following GKRS as the response of large meningiomas may be unpredictable.
引用
收藏
页码:109 / 119
页数:11
相关论文
共 28 条
[1]   Radiosurgery for large-volume (> 10 cm3) benign meningiomas Clinical article [J].
Bledsoe, Jonathan M. ;
Link, Michael J. ;
Stafford, Scott L. ;
Park, Paul J. ;
Pollock, Bruce E. .
JOURNAL OF NEUROSURGERY, 2010, 112 (05) :951-956
[2]   Long-Term Results of Stereotactic Radiosurgery for Skull Base Meningiomas [J].
Chan, Michael D. ;
Sahgal, Arjun .
NEUROSURGERY, 2016, 79 (01) :68-68
[3]   Radiosurgery for parasagittal and parafalcine meningiomas Clinical article [J].
Ding, Dale ;
Xu, Zhiyuan ;
McNeill, Ian T. ;
Yen, Chun-Po ;
Sheehan, Jason P. .
JOURNAL OF NEUROSURGERY, 2013, 119 (04) :871-877
[4]   Initial Gamma Knife Radiosurgery for Large or Documented Growth Asymptomatic Meningiomas: Long-Term Results From a 27-Year Experience [J].
Fu, Junyi ;
Wu, Lisha ;
Peng, Chao ;
Yang, Xin ;
You, Hongji ;
Cao, Linhui ;
Deng, Yinhui ;
Yu, Jinxiu .
FRONTIERS IN ONCOLOGY, 2020, 10
[5]   Gamma Knife surgery of large meningiomas: early response to treatment [J].
Ganz, J. C. ;
Reda, W. A. ;
Abdelkarim, K. .
ACTA NEUROCHIRURGICA, 2009, 151 (01) :1-8
[6]   Gamma Knife radiosurgery for intracranial benign meningiomas: follow-up outcome in 130 patients [J].
Ge, Youlin ;
Liu, Dong ;
Zhang, Zhiyuan ;
Li, Yanhe ;
Lin, Yiguang ;
Wang, Guokai ;
Zong, Yongqing ;
Liu, Enhu .
NEUROSURGICAL FOCUS, 2019, 46 (06) :1-9
[7]   Dose-staged Gamma Knife radiosurgery for meningiomas: A retrospective study in a single center [J].
Gong, Xiu ;
Ding, Jianbo ;
Knisely, Jonathan P. S. ;
Wang, Enmin ;
Pan, Li ;
Wang, Binjiang ;
Zhang, Nan ;
Wu, Hanfeng ;
Dai, Jiazhong ;
Yu, Tonggang ;
Tang, Xuqun .
FRONTIERS IN NEUROLOGY, 2022, 13
[8]  
Goyal-Honavar A., 2022, Indian J Pathol Microbiol, P65
[9]   Is Fractionated Gamma Knife Radiosurgery a Safe and Effective Treatment Approach for Large-Volume (> 10 cm3) Intracranial Meningiomas? [J].
Han, Moon-Soo ;
Jang, Woo-Youl ;
Moon, Kyung-Sub ;
Lim, Sa-Hoe ;
Kim, In-Young ;
Jung, Tae-Young ;
Jung, Shin .
WORLD NEUROSURGERY, 2017, 99 :477-483
[10]   Quantitative tumor volumetric responses after Gamma Knife radiosurgery for meningiomas [J].
Harrison, Gillian ;
Kano, Hideyuki ;
Lunsford, L. Dade ;
Flickinger, John C. ;
Kondziolka, Douglas .
JOURNAL OF NEUROSURGERY, 2016, 124 (01) :146-154