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The use of stereotactic radiosurgery in the management of
meningiomas
Malik
I, Rowe
JG, Walton
L, Radatz
MW, Kemeny
AA
National Centre for Stereotactic Radiosurgery, Royal Hallamshire Hospital,
Sheffield, UK.
This is a systematic review of a consecutive series of 309 meningiomas
treated with gamma knife stereotactic radiosurgery between 1994 and 2000.
There was an extreme selection bias towards lesions unfavourable for
surgery, determined by the patients referred for treatment: 70% of tumours
involved the skull base, 47% specifically the cavernous sinus: 15% of
patients had multiple meningiomatosis or type 2 neurofibromatosis.
Tumour
histology was the main determinant of growth control (p < 0.001), the
5-year actuarial control rates being 87% for typical meningiomas, 49% for
atypical tumours and 0% for malignant lesions.
Complications from
radiosurgery were rare, occurring in 3% of tumours, and were most frequently
trigeminal and eye movement disturbances treating cavernous sinus
meningiomas.
Given the problems inherent in managing these tumours,
radiosurgery is a valuable strategy and adjuvant treatment for these
meningiomas.
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