Abstract
Background: Non-benign meningioma has a known trend to recur repeatedly. The results of Gamma Knife stereotactic radiosurgery (GKS) for recurrent or residual atypical and malignant meningiomas are reported.
Methods: Thirty patients (13 men, 17 women) with World Health Organization (WHO) grade II (24 cases) or grade III (6 cases) intracranial meningiomas underwent GKS. Their age varied from 30 to 86 years (mean 64 years). Before GKS, the tumor was surgically resected in all patients, and 11 of them also underwent conventional external beam radiation therapy, LINAC-based stereotactic radiotherapy (SRT), or intensity-modulated radiation therapy.
Findings: Of the 30 patients, 23 were followed after the initial GKS for a median period of 28 months (range 2–135 months). Local tumor control after treatment was 74 % at 1 year, 52 % at 2 years, and 34 % at 3 years. A total of 15 patients underwent repeat GKS (one to nine times) because of local or distant intracranial tumor progression, seven were subjected to surgical re-resection of the neoplasm, and four had additional SRT. At the time of the last follow-up, 21 patients were alive, and 2 had died. One of the latter expired because of brain tumor progression at 91 months after the initial GKS, and the other patient died from lung cancer.
Conclusions: Although atypical and malignant meningiomas have a trend to recur repeatedly, aggressive tumor management with repeat GKS at the time of progression can provide long survival in these patients.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Debus J, Wuendrich M, Pirzkall A, Hoess A, Schlegel W, Zuna I, Engenralt-Cabillic R, Wannenmacher M (2001) High efficacy of fractionated stereotactic radiotherapy of large base-of-skull meningiomas: long-term results. J Clin Oncol 19:3547–3553
Goldsmith BJ, Wara WM, Wilson CB, Larson DA (1994) Postoperative irradiation for subtotally resected meningiomas. A retrospective analysis of 140 patients treated from 1967 to 1990. J Neurosurg 80:195–201
Hakim R, Alexander E III, Loeffler JS, SHrieve DC, Wen P, Fallon MP, Stieg PE, Black PM (1998) Results of linear accelerator-based radiosurgery for intracranial meningiomas. Neurosurgery 42:446–453
Harris AE, Lee JYK, Omalu B, Flickinger JC, Kondziolka D, Lunsford LD (2003) The effect of radiosurgery during management of aggressive meningiomas. Surg Neurol 60:298–305
Huffmann BC, Reinacher PC, Gilsbach JM (2005) Gamma knife surgery for atypical meningiomas. J Neurosurg 102(Suppl):283–286
Kano H, Takahashi JA, Katsuki T, Araki N, Oya N, Hiraoka M, Hashimoto N (2007) Stereotactic radiosurgery for atypical amd anaplastic meningiomas. J Neurooncol 84:41–47
Kondziolka D, Lunsford LD, Coffy RJ, Flickinger JC (1991) Gamma knife radiosurgery of meningiomas. Stereotact Funct Neurosurg 57:11–21
Kondziolka D, Levy EI, Niranjan A, Flickinger JC, Lunsford LD (1999) Long-term outcomes after meningioma radiosurgery: physician and patient perspective. J Neurosurg 91:44–50
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (2007) WHO classification of tumours of the Central Nervous System. IARC Press, Lyon, pp 164–172
Mattozo CA, De Salles AAF, Klement IA, Gorgulho A, McArthur D, Ford JM, Agazaryan N, Kelly DF, Selch MT (2007) Stereotactic radiation treatment for recurrent non-benign meningiomas. J Neurosurg 106:846–854
Milker-Zabel S, Zabel A, Schulz-Ertner D, Schlegel W, Wannenmacher M, Debus J (2005) Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: long-term experience and prognostic factors. Int J Radiat Oncol Biol Phys 61:809–816
Ojemann SG, Sneed PK, Larson DA, Gutin PH, Berger MS, Verhey L, Smith V, Petti P, Wara W, Park E, McDermott MW (2000) Radosurgery for malignant meningioma: results in 22 patients. J Neurosurg 93(Suppl 3):62–67
Palma L, Celli P, Franco C, Contore G (1997) Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg 86:793–800
Stafford SL, Pollock BE, Foote RL, Link MJ, Gorman DA, Schomberg PJ, Leavitt JA (2001) Meningioma radiosurgery: tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery 49:1029–1038
Conflict of Interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Wien
About this paper
Cite this paper
Mori, Y., Tsugawa, T., Hashizume, C., Kobayashi, T., Shibamoto, Y. (2013). Gamma Knife Stereotactic Radiosurgery for Atypical and Malignant Meningiomas. 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_13
Download citation
DOI: https://doi.org/10.1007/978-3-7091-1376-9_13
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-1375-2
Online ISBN: 978-3-7091-1376-9
eBook Packages: MedicineMedicine (R0)