Functional and Radiographic Outcomes of Cavernous Meningiomas Based on Treatment Modality.

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Cavernous sinus meningiomas (CSMs) pose significant treatment challenges due to their critical location near neurovascular structures.
• Limited comparative data exists on outcomes for different CSM treatment modalities.

Purpose of the Study:

• To compare radiographic and functional outcomes of cavernous sinus meningiomas (CSMs) treated with radiation, surgery ± radiation, or observation.
• To evaluate the efficacy of different treatment strategies for CSMs.

Main Methods:

• Retrospective review of adult patients diagnosed with CSMs between 2009 and 2016.
• Analysis of patient and tumor characteristics, radiographic control rates, and functional outcomes.
• Comparison of outcomes across treatment groups (radiation, surgery, observation) using nonparametric tests.

Main Results:

• Radiographic control rates varied: 100% for surgery, 97.1% for radiation, 69.2% for surgery + radiation, and 90.9% for observation.
• The radiation group showed significant symptom improvement (32.4% complete, 23.1% partial).
• Surgery was associated with a higher likelihood of symptom progression (OR: 5.16, p=0.019).

Conclusions:

• Radiation therapy demonstrates excellent radiographic control for cavernous sinus meningiomas (CSMs).
• Surgery may be indicated for large or symptomatic CSMs, primarily for vision preservation, nerve decompression, and debulking.
• Extensive patient counseling regarding treatment goals and expectations is crucial before surgical intervention.