Fractionated Gamma Knife Radiosurgery as Initial Treatment for Large Skull Base Meningioma.
- Author:
Hye Ran PARK
1
;
Jae Meen LEE
;
Kwang Woo PARK
;
Jung Hoon KIM
;
Sang Soon JEONG
;
Jin Wook KIM
;
Hyun Tai CHUNG
;
Dong Gyu KIM
;
Sun Ha PAEK
Author Information
- Publication Type:Original Article
- Keywords: Gamma Knife Radiosurgery; Dose Hypofractionation; Meningioma; Skull Base; Stereotactic Radiosurgery
- MeSH: Cohort Studies; Cranial Nerve Diseases; Dose Hypofractionation; Follow-Up Studies; Humans; Karnofsky Performance Status; Meningioma*; Mortality; Prospective Studies; Radiosurgery*; Retrospective Studies; Skull Base*; Skull*; Trigeminal Nerve Diseases; Tumor Burden
- From:Experimental Neurobiology 2018;27(3):245-255
- CountryRepublic of Korea
- Language:English
- Abstract: We present our experience on the hypofractionated Gamma Knife radiosurgery (FGKS) for large skull base meningioma as an initial treatment. We retrospectively reviewed 23 patients with large skull base meningioma ≥10 cm³ who underwent FGKS as the initial treatment option. The mean volume of tumors prior to radiosurgery was 21.2±15.63 cm³ (range, 10.09~71.42). The median total margin dose and marginal dose per fraction were 18 Gy (range, 15~20) and 6 Gy (range, 5~6), respectively. Patients underwent three or four fractionations in consecutive days with the same Leksell® frame. The mean follow-up duration was 38 months (range, 17~78). There was no mortality. At the last follow-up, the tumor volume was stationary in 15 patients (65.2%) and had decreased in 8 patients (34.8%). Six patients who had cranial neuropathy at the time of FGKS showed improvement at the last clinical follow-up. Following FGKS, 4 patients (17%) had new cranial neuropathy. The trigeminal neuropathy was the most common and all were transient. The mean Karnofsky Performance Status score at pre-FGKS and the last clinical follow-up was 97.0±10.4 points (median, 100) and 98.6±6.9 (median, 100) points, respectively. FGKS has showed satisfactory tumor control with functional preservation for large skull base meningiomas. Further prospective studies of large cohorts with long term follow-up are required to clarify the efficacy in the tumor control and functional outcome as well as radiation toxicity.
