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Gamma knife stereotactic radiosurgery for radiation-induced meningiomas
Elizabeth N Kuhn1, Michael D Chan, Stephen B Tatter
1Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. ekuhn @ wakehealth.edu
Background:
Radiation-induced meningiomas present a unique clinical dilemma given the fact that patients with these tumors have often received a prior full course of radiotherapy. As such, traditional radiotherapy is limited by lifetime tissue tolerances to radiation, leaving surgery and radiosurgery as attractive treatment options.
Objectives:
To ascertain the safety and efficacy of Gamma Knife radiosurgery as a treatment for radiation-induced meningiomas.
Methods:
A retrospective chart review was conducted to identify patients who received Gamma Knife radiosurgery for a meningioma and met the criteria for this being a radiation-induced tumor. Serial imaging was used to determine the outcome of treatment and clinical notes used to assess for toxicity.
Results:
We present our series of 12 patients with radiation-induced meningiomas treated with Gamma Knife stereotactic radiosurgery over a 12-year period at our institution. With a median follow-up of 35 months, local control was 100%. Two patients experienced distant brain failure (>2 cm from previous radiosurgical volume). Two patients experienced posttreatment toxicity related to treatment-related edema. A review of data collected from the scientific literature suggests that tumor volume predicts for treatment failure of radiosurgery.
Conclusions:
Gamma Knife radiosurgery is both a safe and effective treatment for radiation-induced meningiomas.
