Artikel
Radiosurgery for skull base meningiomas: Clinical Outcomes from over 3500 cases in the medium and very long-term follow-up – update
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Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Skull base Meningiomas are the most frequent benign tumours treated with Gamma Knife Radiosurgery (GKRS). However, the assessment of its efficacy and safety in slow growing tumours is an ongoing process, requiring analysis of long-term results. This study involves the experience of several European Gamma Knife Centers. We report on the efficacy of GKRS for the treatment of skull base Meningiomas, clinical and radiological control and side effects.
Methods: From 15 participating centers, we performed a retrospective observational analysis of a cohort of 3752 benign meningiomas treated with GKRS. All were treated with Gamma Knife radiosurgery at least 5 years before assessment for this study. Clinical and imaging data were retrieved from each center and uniformly entered into a database by 1 author (A.S.). A descriptive imaging and clinical analysis is presented.
Results: 3451 patients harbouring 3752 meningiomas treated in fifteen institutions recruited were evaluated. The median age was 56 years (range 6–89 years). The median tumour volume was 5.20 ccm (range 0.5–85 ccm) and tumour margin dose to the 50% isodose line 13.5 Gy (range 3–45 Gy). The median imaging follow-up was 61 months, but detailed results were only available for 3259 meningiomas (86.8%).
The temporary morbidity rate after GKRS was 5.3% and the permanent morbidity rate was 5.6%. The actuarial control rate was 97.9% at 5 years post GKRS 87,9% at 10 years post GKRS and 78% at 15 years follow-up.
Conclusions: GKRS is a safe and not invasive method of treatment of skull base meningiomas. Imaging tumor control tends to decrease after 10 years follow-up nevertheless with a very low morbidity rate even in the long-term.