Dose-staged Gamma Knife radiosurgery for meningiomas: A retrospective study in a single center
Xiu Gong1, Jianbo Ding2,3, Jonathan P S Knisely4
1Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Objective:
This study aimed to study the efficiency and safety of a dose-staged Gamma Knife radiosurgery strategy for large meningiomas or meningiomas close to important nerve structures.
Methods:
This study evaluates the outcome of a prospectively accrued series of 71 consecutive patients with meningiomas treated with staged dose-fractionated Gamma Knife radiosurgery. The average peripheral doses for the first and second fractions were 9.0 ± 0.9 Gy (8-12 Gy) and 8.6 ± 0.7 Gy (range, 7-10 Gy), respectively. The interval between fractions was 6.1 ± 1.9 months (range, 3-12 months). The median follow-up time was 36 months (12-96 months).
Results:
During the follow-up period after the second fraction, 97.2% achieved tumor control in our series. A total of 2 patients exhibited local recurrence at 30 and 60 months after the second fraction, respectively. No treatment-related complications or new long-term neurological dysfunctions were reported. MRIs observed slightly or moderately increased peritumoral edema in six patients, but no specific neurological complaints are attributed to this finding.
Conclusion:
This study investigates the efficiency and safety of dose-staged Gamma Knife radiosurgery as an alternative option for meningiomas that were large in volume, adjacent to crucial structures, or in patients with contraindications to craniotomy.
