J Korean Neurosurg Soc.  2015 Feb;57(2):77-81. 10.3340/jkns.2015.57.2.77.

Change in Plasma Vascular Endothelial Growth Factor after Gamma Knife Radiosurgery for Meningioma: A Preliminary Study

Affiliations
  • 1Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea. nsdoctor@naver.com

Abstract


OBJECTIVE
The purpose of this study was to investigate changes in the plasma level of vascular endothelial growth factor (VEGF) after Gamma Knife radiosurgery (GKRS) for the treatment of meningioma.
METHODS
Fourteen patients with meningiomas had peripheral venous blood collected at the time of GKRS and at 1 week, 1 month, 3 month and 6 month visits. Plasma VEGF levels were measured using commercially available enzyme-linked immunosorbent assay. For controls, peripheral blood samples were obtained from 20 healthy volunteers.
RESULTS
The mean plasma VEGF level (29.6 pg/mL) in patients with meningiomas before GKRS was significantly lower than that of the control group (62.4 pg/mL, p=0.019). At 1 week after GKRS, the mean plasma VEGF levels decreased to 23.4 pg/mL, and dropped to 13.9 pg/mL at 1 month, 14.8 pg/mL at 3 months, then increased to 27.7 pg/mL at 6 months. Two patients (14.3%) with peritumoral edema (PTE) showed a level of VEGF 6 months after GKRS higher than their preradiosurgical level. There was no significant association found in an analysis of correlation between PTE and tumor size, marginal dose, age, and sex.
CONCLUSION
Our study is first in demonstrating changes of plasma VEGF after stereotactic radiosurgery (SRS) for meningioma. This study may provide a stimulus for more work related to whether measurement of plasma level has a correlation with tumor response after SRS for meningioma.

Keyword

Gamma Knife radiosurgery; Meningioma; Stereotactic radiosurgery; Vascular endothelial growth factor

MeSH Terms

Edema
Enzyme-Linked Immunosorbent Assay
Healthy Volunteers
Humans
Meningioma*
Plasma*
Radiosurgery*
Vascular Endothelial Growth Factor A*
Vascular Endothelial Growth Factor A

Figure

  • Fig. 1 Plasma concentrations of VEGF before and after Gamma Knife radiosurgery (GKRS). VEGF : vascular endothelial growth factor.

  • Fig. 2 Enhanced T1-weighted (A) and T2-weighted (B) magnetic resonance (MR) imaging obtained in a 60-year-old women who had a parasagittal meningioma. GKRS was performed with a margin dose of 13 Gy to the 50% isodose line. The MR image obtained 6 months after GKRS shows increased tumor volume from 1.6 mm3 to 2.2 mm3 (C) and a new peritumoral edema (D). GKRS : Gamma Knife radiosurgery.


Cited by  1 articles

Systemic Expression of Vascular Endothelial Growth Factor in Patients with Cerebral Cavernous Malformation Treated by Stereotactic Radiosurgery
Sang-Jin Park, Seong-Hyun Park
J Korean Neurosurg Soc. 2016;59(5):442-448.    doi: 10.3340/jkns.2016.59.5.442.


Reference

1. Chang JH, Chang JW, Choi JY, Park YG, Chung SS. Complications after gamma knife radiosurgery for benign meningiomas. J Neurol Neurosurg Psychiatry. 2003; 74:226–230. PMID: 12531956.
Article
2. Ganz JC, Schröttner O, Pendl G. Radiation-induced edema after Gamma Knife treatment for meningiomas. Stereotact Funct Neurosurg. 1996; 66(Suppl 1):129–133. PMID: 9032853.
Article
3. Ilhan A, Gartner W, Neziri D, Czech T, Base W, Hörl WH, et al. Angiogenic factors in plasma of brain tumour patients. Anticancer Res. 2009; 29:731–736. PMID: 19331229.
4. Kan P, Liu JK, Wendland MM, Shrieve D, Jensen RL. Peritumoral edema after stereotactic radiosurgery for intracranial meningiomas and molecular factors that predict its development. J Neurooncol. 2007; 83:33–38. PMID: 17245625.
Article
5. Kim GH, Hahn DK, Kellner CP, Hickman ZL, Komotar RJ, Starke RM, et al. Plasma levels of vascular endothelial growth factor after treatment for cerebral arteriovenous malformations. Stroke. 2008; 39:2274–2279. PMID: 18535271.
Article
6. Klatte T, Böhm M, Nelius T, Filleur S, Reiher F, Allhoff EP. Evaluation of peri-operative peripheral and renal venous levels of pro- and anti-angiogenic factors and their relevance in patients with renal cell carcinoma. BJU Int. 2007; 100:209–214. PMID: 17428240.
Article
7. Kondziolka D, Flickinger JC, Perez B. Gamma Knife Meningioma Study Group. Judicious resection and/or radiosurgery for parasagittal meningiomas : outcomes from a multicenter review. Neurosurgery. 1998; 43:405–413. discussion 413-414. PMID: 9733295.
Article
8. Kondziolka D, Levy EI, Niranjan A, Flickinger JC, Lunsford LD. Long-term outcomes after meningioma radiosurgery : physician and patient perspectives. J Neurosurg. 1999; 91:44–50. PMID: 10389879.
Article
9. Kraft A, Weindel K, Ochs A, Marth C, Zmija J, Schumacher P, et al. Vascular endothelial growth factor in the sera and effusions of patients with malignant and nonmalignant disease. Cancer. 1999; 85:178–187. PMID: 9921991.
Article
10. Nakamura S, Hiyama H, Arai K, Nakaya K, Sato H, Hayashi M, et al. Gamma Knife radiosurgery for meningiomas : four cases of radiation-induced edema. Stereotact Funct Neurosurg. 1996; 66(Suppl 1):142–145. PMID: 9032855.
Article
11. Novotný J Jr, Kollová A, Liscák R. Prediction of intracranial edema after radiosurgery of meningiomas. J Neurosurg. 2006; 105(Suppl):120–126. PMID: 18503344.
Article
12. Poon RT, Ng IO, Lau C, Zhu LX, Yu WC, Lo CM, et al. Serum vascular endothelial growth factor predicts venous invasion in hepatocellular carcinoma : a prospective study. Ann Surg. 2001; 233:227–235. PMID: 11176129.
Article
13. Preusser M, Hassler M, Birner P, Rudas M, Acker T, Plate KH, et al. Microvascularization and expression of VEGF and its receptors in recurring meningiomas : pathobiological data in favor of anti-angiogenic therapy approaches. Clin Neuropathol. 2012; 31:352–360. PMID: 22541785.
Article
14. Schmid S, Aboul-Enein F, Pfisterer W, Birkner T, Stadek C, Knosp E. Vascular endothelial growth factor : the major factor for tumor neovascularization and edema formation in meningioma patients. Neurosurgery. 2010; 67:1703–1708. discussion 1708. PMID: 21107201.
Article
15. Senger DR, Galli SJ, Dvorak AM, Perruzzi CA, Harvey VS, Dvorak HF. Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science. 1983; 219:983–985. PMID: 6823562.
Article
16. Torres RC, Frighetto L, De Salles AA, Goss B, Medin P, Solberg T, et al. Radiosurgery and stereotactic radiotherapy for intracranial meningiomas. Neurosurg Focus. 2003; 14:e5. PMID: 15669816.
Article
17. Vermeulen S, Young R, Li F, Meier R, Raisis J, Klein S, et al. A comparison of single fraction radiosurgery tumor control and toxicity in the treatment of basal and nonbasal meningiomas. Stereotact Funct Neurosurg. 1999; 72(Suppl 1):60–66. PMID: 10681692.
Article
18. Yamamoto Y, Toi M, Kondo S, Matsumoto T, Suzuki H, Kitamura M, et al. Concentrations of vascular endothelial growth factor in the sera of normal controls and cancer patients. Clin Cancer Res. 1996; 2:821–826. PMID: 9816236.
Full Text Links
  • JKNS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr