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22.05.2019 | Clinical Study

Multisession radiosurgery for perioptic meningiomas: medium-to-long term results from a CyberKnife cooperative study

verfasst von: Marcello Marchetti, Alfredo Conti, Giancarlo Beltramo, Valentina Pinzi, Antonio Pontoriero, Irene Tramacere, Carolin Senger, Stefano Pergolizzi, Laura Fariselli

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2019

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Abstract

Purpose

Most recent literature has confirmed the efficacy of single-session radiosurgery (sRS) in the treatment of intracranial meningioma. Unfortunately, sRS is not always applicable due to large tumor volume and the proximity of the tumor to critical structures. When sRS is not recommended, multi-session radiosurgery (mRS) can be the solution. The best treatment schedule for mRS, however, is not well established. The aim of the present retrospective study is to validate the effectiveness of one approach, 25 Gy delivered in 5 fractions in 5 consecutive days, to treat skull base meningiomas.

Methods

This is a retrospective multicenter study. Patients with an anterior or a medium skull base meningioma that could not be treated by sRS due to large volume or proximity to the anterior optic pathways (AOPs) underwent 5-fraction mRS. Only patients with at least 36 months follow-up were included in the analysis. Local control and visual outcomes were investigated.

Results

One-hundred-sixty-seven patients were included in the analysis. One-hundred-one patients underwent RS as a primary indication and 66 were treated after a previous surgery. The median follow-up period was 51 months (range 36–129 months). Progression-free survival at 3, 5 and 8 years were, respectively, 98%, 94% and 90%. Excluding the progressive disease patients, the visual worsening rate was 3.7%. The 42% of the patients with a pre-treatment visual deficit experienced improvement in vision.

Conclusion

25 Gy delivered in 5 fractions is an effective modality for meningiomas that are near the AOP or are too large to be treated by sRS. The treatment schedule controlled the tumors while sparing visual function.

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Titel: Multisession radiosurgery for perioptic meningiomas: medium-to-long term results from a CyberKnife cooperative study
verfasst von: Marcello Marchetti
Alfredo Conti
Giancarlo Beltramo
Valentina Pinzi
Antonio Pontoriero
Irene Tramacere
Carolin Senger
Stefano Pergolizzi
Laura Fariselli
Publikationsdatum: 22.05.2019
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03196-x

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