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Linear accelerator-based radiosurgery in the
management of skull base meningiomas
Chuang CC, Chang CN, Tsang NM, Wei KC, Tseng CK, Chang JT, Pai PC
First Division of Neurosurgery, Chang Gung Memorial Hospital,
Chang Gung University, Linkou, Taiwan, ROC.
From May 1994 to December 1999, 43 patients with meningiomas in the base of the
skull underwent linear accelerator (LINAC)-based stereotactic radiosurgery (SRS)
at Chung Gung Memorial Hospital.
SRS was performed as a primary treatment in 14 patients, and after resection in
29 patients.
The mean tumor volume was 5.68 cc, and the mean target surface dose was 16 Gy,
delivered with an average of three isocenters.
The median follow-up was 74.5 months.
The 7-year local control rate and 7-year overall survival rate were 89.7% and
80.2%, respectively.
The 7-year local control was 100% and 84.4% in SRS alone group and surgical
excision with SRS group (p = 0.21), respectively.
A stationary tumor following SRS was seen in 23 (53.5%) patients, partial
shrinkage was seen in 16 (37.2%) patients, and complete disappearance in one
patient was seen (2.3%).
Furthermore, disease progression was noted in three (7%) patients, one of whom
died of disease.
The median time to tumor response was 15.4 months (range 5.8-52.8 months).
Cases remained stable or had improved neurological statuses without any
deterioration in 37.9% and 78.7% of the groups treated with surgery and SRS and
SRS alone, retrospectively.
In summary, LINAC-based SRS is an effective and safe modality of treating
unresectable or partially resected meningiomas in the base of the skull.
For tumors with diameters of 3 cm or less, particularly in patients without or
with minimal clinical neurological symptom, SRS alone can provide a good local
control without causing cranial neuropathy.
PMID: 15015792 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15015792 |
