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The long-term outcome of CyberKnife-based stereotactic radiotherapy for central skull base meningiomas: a single-center experience

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Abstract

Few reports exist demonstrating the effects of stereotactic radiotherapy (SRT) on the central skull base meningiomas (CSMs). A retrospective analysis of 113 patients was performed. The median age was 62 (IQR 50–72) years old, and 78 patients (69%) were female. Upfront SRT was performed in 41 (36%), where 17 (15%) patients were asymptomatic. The other SRT was for postoperative adjuvant therapy in 32 (28%), and for the recurrent or relapsed tumors in 40 (35%) patients. Previous operation was done in 74 patients (66%). Among the available pathology in 46 patients, 37 (80%) were WHO grade I, 8 (17%) were grade II, and 1 (2%) was grade III. The median prescribed dose covered 95% of the planning target volume was 25 (IQR 21–25) Gy, and the median target volume was 9.5 (IQR 3.9–16.9) cm3. The median progression-free survival (PFS) was 48 (IQR 23–73) months and 84% and 78% were free of tumor progression at 5 and 10 years respectively. The median follow-up was 49 (IQR 28–83) months. PFS was better in grade I than grade II (p = 0.02). No other baseline factors including the history of previous operation were associated with PD or PFS. Adverse events of radiation therapy were radiation-induced optic neuropathy (0.9%), and cerebral edema (4.4%). Asymptomatic cavernous carotid stenosis was found in three (2.7%), five (4.4%) underwent ventriculoperitoneal shunt placement for normal pressure hydrocephalus, and five (4.4%) died. SRT is useful for the management of CSMs with a low rate of adverse events.

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Authors and Affiliations

  1. Department of Neurosurgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya City, Tokyo, 150-8935, Japan

    Sukwoo Hong, Kengo Sato, Kenji Kagawa & Shunsuke Ichi

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  1. Sukwoo Hong
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  2. Kengo Sato
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  3. Kenji Kagawa
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  4. Shunsuke Ichi
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Contributions

All authors read and approved the final manuscript. SH made a study design, collected patient data, and drafted and revised the manuscript. KK contributed to revising the original draft. KS and SI were the supervisors.

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Correspondence to Sukwoo Hong.

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This study was done under our institutional review board’s approval and did not require patient consent.

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Our institutional review board did not require informed consent for study participation because this study relied on information obtained as part of routine clinical practice.

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The authors declare no competing interests.

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Hong, S., Sato, K., Kagawa, K. et al. The long-term outcome of CyberKnife-based stereotactic radiotherapy for central skull base meningiomas: a single-center experience. Neurosurg Rev 44, 3519–3526 (2021). https://doi.org/10.1007/s10143-021-01535-z

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