DEVELOPMENT OF DOSE-VOLUME RELATION MODEL FOR GAMMA KNIFE SURGERY OF NON-SKULL BASE INTRACRANIAL MENINGIOMAS

Abstract

Purpose: To provide a dose-volume relationship for gamma knife surgery (GKS) of non-skull base intracranial meningiomas. Methods and Materials: The radiologic outcomes of GKS of 82 imaging-defined benign meningiomas located at non-skull base areas were analyzed. A total of 80 patients were included and all underwent treatment with GKS as the first and the only treatment modality. The mean patient age was 55.0 years (range, 26-78) and the mean tumor volume was 5.6 cm(3) (range, 0.5-16.8). On average, 14.6 Gy (range, 10-20) was applied to the 50% isodose surface. The binary logistic regression method was applied to find prognostic factors of signal change (SC) on T(2)-weighted magnetic resonance imaging after GKS. Results: The actuarial tumor control rate was 91.6% at 5 years. A total of 29 lesions (35.4%) showed newly developed or aggravated SCs. The volume irradiated >= 14 Gy was the only statistically significant (p < .01) prognostic factor of SC. A dose-volume relation model obtained from the cases without SC estimated a 12.2% SC probability. Conclusion: This model can be used in GKS to treat small- to medium-size (<9.2 cm(3)) non-skull base meningiomas.