Document Detail


Gamma Knife radiosurgery for skull base meningioma: long-term results of low-dose treatment.
MedLine Citation:
PMID:  18976068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: In this study, the authors evaluate the long-term results after Gamma Knife radiosurgery of cranial base meningiomas. This study is a follow-up to their previously published report on the early results. METHODS: Between January 1994 and December 2001, the authors treated benign cranial base meningiomas in 108 patients using low-dose Gamma Knife radiosurgery. The tumor volumes ranged from 1.7 to 55.3 cm3 (median 8.1 cm3), and the radiosurgery doses ranged from 8 to 12 Gy (median 12 Gy) to the tumor margin. RESULTS: The mean duration of follow-up was 86.1 months (range 20-144 months). Tumor volume decreased in 50 patients (46%), remained stable in 51 patients (47%), and increased (local failure) in 7 patients (6%). Eleven patients experienced tumor recurrence outside the treatment field. Among these patients, marginal failure was seen in 5 and distant recurrence was seen in 6. Seven patients were thought to have malignant transformation based on histological or radiological characteristics of the lesion. The actuarial progression-free survival rate, including malignant transformation and outside recurrence, was 93% at 5 years and 83% at 10 years. Neurological status improved in 16 patients (15%). Permanent radiation injury occurred in 7 patients (6%). CONCLUSIONS: Gamma Knife radiosurgery is a safe and effective treatment for cranial base meningiomas as demonstrated with a long-term follow-up period of > 7 years. Surgeons must be aware of the possibility of treatment failure, defined as local failure, marginal failure, and malignant transformation; however, this may be the natural course of meningiomas and not related to radiosurgery.
Authors:
Yoshiyasu Iwai; Kazuhiro Yamanaka; Hidetoshi Ikeda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  109     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-03     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  804-10     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan. y-iwai@rc5.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Kaplan-Meiers Estimate
Magnetic Resonance Imaging
Male
Meningioma / pathology,  surgery*
Middle Aged
Neoplasm Recurrence, Local
Radiosurgery / adverse effects,  methods*
Skull Base Neoplasms / pathology,  surgery*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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