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Stereotactic radiosurgery for cerebellopontine angle meningiomas
Seong-Hyun Park1, Hideyuki Kano, Ajay Niranjan
1Departments of Neurological Surgery and.
Journal of Neurosurgery
|December 17, 2013
Summary
Stereotactic radiosurgery (SRS) offers excellent long-term tumor control for cerebellopontine angle meningiomas. While generally safe, trigeminal nerve compression can increase the risk of facial pain worsening post-treatment.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Cerebellopontine angle (CPA) meningiomas are tumors that can cause significant neurological deficits.
- Long-term outcomes of stereotactic radiosurgery (SRS) for these tumors require comprehensive evaluation.
Purpose of the Study:
- To assess the long-term efficacy and safety of SRS for CPA meningiomas.
- To evaluate tumor control and clinical symptom changes after SRS.
Main Methods:
- Retrospective review of 74 patients with CPA meningiomas treated with SRS between 1990 and 2010.
- Analysis of progression-free survival, tumor volume changes, and clinical symptom evolution.
- Median follow-up of 40 months.
Main Results:
- High tumor control rates: 95% progression-free survival at 5 years.
- Tumor volume decreased in 62% and stabilized in 35% of patients.
- Neurological improvement observed in 31% at 3 years and 40% at 5 years, with a 16% deterioration rate at 5 years. Trigeminal neuralgia was associated with worsening facial pain (p=0.001).
- Adverse radiation effects occurred in 9% of patients.
Conclusions:
- SRS provides durable tumor control for CPA meningiomas with a low risk of severe adverse effects.
- Pre-existing trigeminal nerve compression is a risk factor for post-SRS facial pain worsening.
