Abstract
Objective: Results of Gamma Knife radiosurgery (GKS) were retrospectively evaluated in 16 patients with histologically confirmed atypical and anaplastic intracranial meningiomas.
Materials and Methods: There were nine men and seven women (mean age 61.0 years). Atypical meningiomas were diagnosed in nine cases and anaplastic meningiomas in seven. In nine patients there was malignant transformation of a tumor that had initially proved to be benign. In total, 21 radiosurgical procedures were performed. The mean tumor volume at the time of GKS was 7.1 cm3. The mean marginal and maximum irradiation doses were 18.8 and 37.0 Gy, respectively. The mean length of follow-up after treatment was 37.1 months.
Findings: Of 21 radiosurgical procedures, 6 (29 %) led to stabilization of tumor growth during the mean follow-up of 40.5 months. It was significantly associated with small lesion volume (P = 0.02), and greater marginal (P = 0.04) and maximum (P = 0.02) irradiation doses. Seven patients underwent eight surgical resections of a progressing tumor during the mean period of 26.1 months after irradiation. Five patients (31 %) died because of tumor progression within the average time period of 16.8 months after GKS. Overall, at the time of the last follow-up just two patients (13 %) had no evidence of tumor regrowth, and only three patients (19 %) maintained good activities of daily living during 12, 59, and 69 months, respectively, after radiosurgery.
Conclusion: GKS has limited efficacy in cases of non-benign meningioma. Better tumor control rates can be attained for small neoplasms treated with greater marginal and maximum irradiation doses.
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Acknowledgment
This study used a Grant-in-Aid for Scientific Research (B) No. 22300093 and was supported by the Global COE Program: The Multidisciplinary Education and Research Centre for the Establishment of Regenerative Medicine (MERCREM), Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan. Additional support was obtained from the Japan Society for the Promotion of Science (JSPS) through the “Funding Program for World-Leading Innovative R&D on Science and Technology (FIRST Program)” initiated by the Council for Science and Technology Policy (CSTP). The authors are grateful to Gautam A. Deshpande, M.D. for his assistance with editing the manuscript.
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The authors declare that they have no conflict of interest.
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Tamura, M. et al. (2013). Management of Non-benign Meningiomas with Gamma Knife Radiosurgery. In: Chernov, M., Hayashi, M., Ganz, J., Takakura, K. (eds) Gamma Knife Neurosurgery in the Management of Intracranial Disorders. Acta Neurochirurgica Supplement, vol 116. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1376-9_14
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DOI: https://doi.org/10.1007/978-3-7091-1376-9_14
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