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Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study
Adomas Bunevicius1, Stylianos Pikis1, Rithika Kormath Anand1
1Department of Neurosurgery, University of Virginia, Charlottesville, VA, 22908, USA.
Acta Neurochirurgica
|August 24, 2021
Summary
Stereotactic radiosurgery (SRS) offers durable control for clinoid meningiomas, preserving vision in most patients. Higher SRS doses improve tumor control, but doses to the optic apparatus over 10 Gy and pre-existing visual deficits increase risks.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Resection of clinoid meningiomas is linked to significant morbidity.
- Experience with stereotactic radiosurgery (SRS) for these tumors is limited.
Purpose of the Study:
- To evaluate the safety and effectiveness of SRS for clinoid meningiomas.
- To assess tumor control and visual outcomes after SRS treatment.
Main Methods:
- A pooled analysis of 207 patients with WHO grade I clinoid meningiomas treated with SRS across 12 institutions.
- Median follow-up was 51.1 months for imaging and 48 months for visual function.
Main Results:
- Tumor progression occurred in 7% of patients, with higher SRS margin dose and pre-SRS radiotherapy predicting better control.
- Visual function declined in 8% of patients; pre-SRS visual deficit and maximal optic apparatus dose ≥10 Gy predicted decline.
- Four patients developed new cranial nerve V neuropathy post-SRS.
Conclusions:
- SRS provides durable tumor control and preserves vision in the majority of patients with clinoid meningiomas.
- Higher SRS doses enhance tumor control, while higher radiation doses to the optic apparatus and pre-existing visual deficits increase the risk of visual deterioration.
