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Gamma knife radiosurgery for skull base meningiomas
B E Pollock1, S L Stafford, M J Link
1Department of Neurological Surgery, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Neurosurgery Clinics of North America
|November 18, 2000
Summary
Radiosurgery offers safe and effective long-term growth control for skull base meningiomas, with a less than 10% incidence of new cranial nerve deficits. This treatment is highly effective, achieving over 90% tumor growth control.
Area of Science:
- Neurosurgery
- Radiation Oncology
Background:
- Skull base meningiomas require effective management strategies.
- Microsurgical resection can be associated with significant morbidity.
- Radiosurgery presents an alternative or adjuvant treatment option.
Purpose of the Study:
- To evaluate the safety and efficacy of radiosurgery for skull base meningiomas.
- To assess tumor growth control and incidence of cranial nerve deficits.
- To explore radiosurgery as part of a multimodality approach for large tumors.
Main Methods:
- Utilized stereotactic MR imaging for precise tumor margin definition.
- Employed multiisocenter conformal dose planning for radiosurgery.
- Analyzed outcomes including tumor growth control and new cranial nerve deficits.
Main Results:
- Radiosurgery demonstrated long-term tumor growth control exceeding 90%.
- The incidence of new cranial nerve deficits was reduced to less than 10%.
- Tumor growth after radiosurgery was often associated with tumors outside the irradiated volume or atypical/malignant histology.
Conclusions:
- Radiosurgery is a safe and effective treatment for skull base meningiomas, offering durable tumor growth control.
- It provides an advantage over conventional fractionated radiation therapy due to its steep radiation falloff.
- A staged approach combining microsurgery and radiosurgery can reduce morbidity for large tumors while maintaining long-term control.