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Gamma knife radiosurgery for skull base meningiomas: long-term radiologic and clinical outcome

Cited 61 time in Web of Science Cited 60 time in Scopus
Authors
Han, Jung Ho; Kim, Dong Gyu; Chung, Hyun-Tai; Park, Chul-Kee; Paek, Sun Ha; Kim, Chae-Yong; Jung, Hee-Won
Issue Date
2008-10-17
Publisher
Elsevier
Citation
Int J Radiat Oncol Biol Phys. 2008;72(5):1324-1332
Keywords
Age of OnsetAntineoplastic Combined Chemotherapy Protocols/*therapeutic useChildChild, PreschoolCombined Modality TherapyFollow-Up StudiesHumansInfantMeningeal Neoplasms/drug therapy/pathology/*surgeryMeningioma/drug therapy/pathology/*surgery*Radiosurgery/methodsRecurrenceReoperation/statistics & numerical dataRetrospective StudiesSkull Base Neoplasms/drug therapy/pathology/*surgerySupratentorial Neoplasms/drug therapy/pathology/*surgeryTime FactorsTreatment Outcome
Abstract
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.
ISSN
1879-355X (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18922647

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T7X-4TNTM2K-1-1&_cdi=5070&_user=168665&_orig=search&_coverDate=12%2F01%2F2008&_sk=999279994&view=c&wchp=dGLbVlb-zSkzk&md5=738106a514f34ed9ba125bc5d5fac3e8&ie=/sdarticle.pdf

https://hdl.handle.net/10371/68404
DOI
https://doi.org/10.1016/j.ijrobp.2008.03.028
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Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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