Brain Tumor Res Treat.  2015 Oct;3(2):103-107. 10.14791/btrt.2015.3.2.103.

Long-Term Results of Gamma Knife Radiosurgery for Intracranial Meningioma

• Jang CK
• Jung HH
• Chang JH
• Chang JW
• Park YG
• Chang WS

• KMID: 2114655
• DOI: http://doi.org/10.14791/btrt.2015.3.2.103

Abstract

BACKGROUND
The predominant treatment modality for meningioma is surgical resection. However, gamma knife radiosurgery is also an important treatment modality for meningioma that is small or cannot be completely removed because of its location. In this study, we evaluated the effectiveness and long-term results of radiosurgical treatment for meningioma in our institution.
METHODS
We studied 628 patients (130 men and 498 women) who underwent gamma knife radiosurgery for intracranial meningioma, which is radiologically diagnosed, from Jan 2008 to Nov 2012. We included patients with single lesion meningioma, and followed up after 6 months with imaging, and then at 24 months with a clinical examination. Patients with high-grade meningioma or multiple meningiomas were excluded. We analyzed each of the factors associated with progression free survival. The median patient's age was 56.8 years. Maximal dosage was 27.8 Gy and marginal dosage was 13.9 Gy.
RESULTS
The overall tumor control rate was 95%. Twenty-eight patients (4.4%) showed evidence of tumor recurrence. Ninety-eight patients (15%) developed peritumoral edema (PTE) after gamma-knife surgery; two of them (2%) underwent surgical resections due to PTE. Nine patients had craniotomy and tumor removal after gamma knife surgery.
CONCLUSION
Gamma knife surgery for intracranial meningioma has proven to be a safe and effective treatment tool with successful long-term outcomes. Gamma knife radiosurgery can be especially effective in cases of remnant meningioma after surgical resection or where PTE is not present.

Keyword

Meningioma; Radiosurgery; Stereotactic

MeSH Terms

Craniotomy
Disease-Free Survival
Edema
Humans
Male
Meningioma*
Radiosurgery*
Recurrence

Figure

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  Fig. 1 Overall survival. FUD, follow-up duration (months).

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  Fig. 2 Influence of primary surgery or post-surgery remnant lesion radiation on progression free survival. FUD, follow-up duration (months).

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  Fig. 3 Influence of peritumoral edema on progression free survival. FUD, follow-up duration (months).

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  Fig. 4 Influence of gender on progression free survival. FUD, follow-up duration (months).

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  Fig. 5 Magnetic resonance images of a representative case. A 62-year-old man received gamma knife surgery for parasagittal meningioma with invasion of superior sagittal sinus. A: Axial T1-weighted magnetic resonance (MR) image obtained in Dec 2006 showing homogeneous enhancing round mass with invasion of superior sagittal sinus. B: Axial T1-weighted MR image from Aug 2009 (post gamma knife surgery 32 months) showing increased heterogeneous enhancing round mass with aggravated peritumoral edema. C: Axial T1-weighted MR image from Sep 2009 (post-operation) showing no remnant lesion.

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