Radiosurgery: an effective treatment for cavernous sinus meningiomas?

Area of Science:

• Neurosurgery
• Oncology

Background:

• Cavernous sinus meningiomas present neurosurgeons with observation, microsurgery, or radiosurgery options.
• Advances in microsurgery have reduced treatment morbidity, with some reporting long-term results.
• Radiosurgery shows promise for tumor control and functional preservation in this region.

Purpose of the Study:

• Critically review radiosurgical series for cavernous sinus meningiomas.
• Discuss the advantages and disadvantages of microsurgery versus radiosurgery.
• Propose a uniform reporting strategy and a treatment algorithm for these tumors.

Main Methods:

• Critical review of existing radiosurgical series.
• Comparative analysis of microsurgery and radiosurgery outcomes.
• Development of a proposed treatment algorithm based on patient-specific factors.

Main Results:

• Radiosurgical series often lack comprehensive cranial nerve function and outcome data.
• Short follow-up periods in radiosurgery studies are a concern due to meningioma recurrence potential.
• Microsurgery may have limited success in patients who do not respond to radiosurgery.

Conclusions:

• Standardized reporting is crucial for comparative studies of cavernous sinus meningiomas.
• A novel treatment algorithm considering patient age, occupation, preference, and tumor curability is suggested.
• The proposed algorithm aims to optimize treatment selection for cavernous sinus meningiomas.