Document Detail


Gamma knife radiosurgery for skull base meningiomas: long-term radiologic and clinical outcome.
MedLine Citation:
PMID:  18922647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze the long-term outcomes in patients with skull base meningiomas (SBMNGs) treated with Gamma Knife radiosurgery (GKRS). METHODS AND MATERIALS: Of the 98 consecutive patients with SBMNGs treated with GKRS between 1998 and 2002, 63 were followed up for more than 48 months. The mean (+/-SD) age of the patients was 50 +/- 12 years, the mean tumor volume was 6.5 cm(3) (range, 0.5-18.4 cm(3)), the mean marginal dose was 12.6 Gy (range, 7.0-20.0 Gy), and the mean follow-up duration was 77 +/- 18 months. The mean number of shots was 13.7 +/- 3.8. The tumor volume was decreased at the last follow-up in 28 patients (44.4%) and increased in 6 (9.6%). The actuarial tumor control rate was 90.2% at 5 years. No notable prognostic factor related to tumor control was identified. Ten patients (15.9%) with a cranial neuropathy showed unfavorable outcomes. The rate of improvement in patients with a cranial neuropathy was 45.1%. Age >70 years was likely correlated with an unfavorable outcome in patients with cranial neuropathy (odds ratio = 0.027; p = 0.025; 95% confidence interval 0.001-0.632). Cavernous sinus location was significantly associated with improvement of a cranial neuropathy (odds ratio = 7.314; p = 0.007; 95% confidence interval 1.707-31.34). CONCLUSIONS: Gamma Knife radiosurgery is an effective modality for the treatment of SBMNGs and provides favorable outcomes in patients with cranial neuropathy, even in the long-term follow-up period. However, radiosurgery for patients with no or only mild symptoms should be performed cautiously because neither complication rate is low enough to be negligible, especially in elderly patients. A cranial neuropathy by MNGs involving the cavernous sinus seems to have a higher chance of improvement after radiosurgery than other SBMNGs.
Authors:
Jung Ho Han; Dong Gyu Kim; Hyun-Tai Chung; Chul-Kee Park; Sun Ha Paek; Chae-Yong Kim; Hee-Won Jung
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Publication Detail:
Type:  Journal Article     Date:  2008-10-14
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  72     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2008-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1324-32     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Age of Onset
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Child
Child, Preschool
Combined Modality Therapy
Follow-Up Studies
Humans
Infant
Meningeal Neoplasms / drug therapy,  pathology,  surgery*
Meningioma / drug therapy,  pathology,  surgery*
Radiosurgery* / methods
Recurrence
Reoperation / statistics & numerical data
Retrospective Studies
Skull Base Neoplasms / drug therapy,  pathology,  surgery*
Supratentorial Neoplasms / drug therapy,  pathology,  surgery*
Time Factors
Treatment Outcome

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


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