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Published on: October 2, 2014
Gamma Knife Radiosurgery for Patients with Multiple Intracranial Meningiomas
Wei Chen1, Xiaoyu Wang1, Fujun Liu1
1Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
Objective:
The aim of this study was to evaluate the safety and efficacy of Gamma Knife radiosurgery (GKRS) in patients with multiple intracranial meningiomas (MIMs).
Methods:
The authors performed a retrospective analysis of 42 consecutive patients (7 men and 35 women) with MIMs who underwent GKRS. The median age of the patients at the time of GKRS was 57.5 years (range, 27-77 years). A total of 115 tumors among 42 patients were identified through imaging or postoperative histopathologic examination, of which 90 were treated with GKRS.
Results:
Follow-up imaging studies were available for 75 tumors in 36 patients (83.3%), with a mean follow-up period of 45.0 months (range, 6.6-90.4 months); 41 patients (97.6%) received clinical follow-up for 16.7 to 106.7 months (average, 57.1 months). Local tumor control was achieved in 68 tumors (90.7%) at the last follow-up. On univariate analysis, surgical resection before GKRS more than once (P = 0.048) and high World Health Organization (WHO) classification (grades II and III) (P = 0.001) were associated with tumor progression. Patients with worsening clinical manifestation showed correlation with peritumor edema (P < 0.001) and had >2 lesions treated by GKRS (P < 0.001) on univariate analysis.
Conclusions:
GKRS is a safe and effective treatment for MIMs. Variables including surgical resection before GKRS more than once, high grade WHO classification, peritumor edema, and >2 tumors treated by GKRS are predictors of unfavorable outcome after GKRS.
Insights
Gamma Knife radiosurgery (GKRS) is safe and effective for multiple intracranial meningiomas (MIMs). Factors like prior surgeries, high tumor grade, edema, and multiple lesions predict poorer outcomes.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Multiple intracranial meningiomas (MIMs) present complex treatment challenges.
- Gamma Knife radiosurgery (GKRS) offers a minimally invasive therapeutic option.
Purpose of the Study:
- To evaluate the safety and efficacy of GKRS for treating MIMs.
- To identify predictors of treatment outcomes in patients with MIMs.
Main Methods:
- Retrospective analysis of 42 patients with MIMs treated with GKRS.
- Inclusion of 90 treated tumors from a total of 115 identified lesions.
- Follow-up included imaging and clinical assessments.
Main Results:
- Local tumor control was achieved in 90.7% of treated tumors.
- Tumor progression was associated with multiple prior surgical resections and high WHO tumor grade (II/III).
- Clinical deterioration correlated with peritumor edema and treatment of more than two lesions.
Conclusions:
- GKRS demonstrates safety and efficacy in managing MIMs.
- Predictors of unfavorable outcomes include prior extensive surgery, high-grade histology, peritumor edema, and extensive lesion burden.
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