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Journal of Neuro-Oncology

, Volume 139, Issue 2, pp 341–348 | Cite as

Cranial nerve outcomes after primary stereotactic radiosurgery for symptomatic skull base meningiomas

  • Andrew Faramand
  • Hideyuki KanoEmail author
  • Ajay Niranjan
  • Stephen A. Johnson
  • Mohab Hassib
  • Kyung-Jae Park
  • Yoshio Arai
  • John C. Flickinger
  • L. Dade Lunsford
Clinical Study

Abstract

Objective

To evaluate cranial nerve (CN) outcomes after primary stereotactic radiosurgery (SRS) for petroclival, cavernous sinus, and cerebellopontine angle meningiomas.

Methods

From our prospectively maintained database of 2022 meningioma patients who underwent Leksell stereotactic radiosurgery (SRS) during a 30-year interval, we found 98 patients with petroclival, 242 with cavernous sinus, and 55 patients with cerebellopontine angle meningiomas. Primary radiosurgery was performed in 245 patients. Patients included in this report had at least one CN deficit at the time of initial presentation and a minimum of 12 month follow up. Median age at the time of SRS was 58 years. Median follow up was 58 months (range 12–300 months), Median tumor volume treated with SRS was 5.9 cm3 (range 0.5–37.5 cm3), and median margin dose was 13 Gy (range 9–20Gy).

Results

Tumor control was achieved in 229 patients (93.5%) at a median follow up of 58 months. Progression free survival rate (PFS) after SRS was 98.7% at 1 year, 96.4% at 3 years, 93.7% at 5 years, and 86.4% at 10 years Overall, 114 of the 245 patients (46.5%) reported improvement of CN function. Patients with CP angle meningiomas demonstrated lower rates of CN improvement compared to petroclival and cavernous sinus meningioma patients. Deterioration of CN function after SRS developed in 24 patients (10%). The rate of deterioration was 2.8% at 1 year, 5.2% at 3 years, and 8% at 10 years.

Conclusion

Primary SRS provides effective tumor control and favorable rate of improvement of preexisting CN deficit.

Keywords

Radiosurgery Skull base Meningioma Cranial nerve 

Notes

Compliance with ethical standards

Disclosures

Dr. Lunsford is a consultant for and stockholder in Elekta AB.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Andrew Faramand
    • 1
  • Hideyuki Kano
    • 1
    • 3
    Email author
  • Ajay Niranjan
    • 1
  • Stephen A. Johnson
    • 1
  • Mohab Hassib
    • 1
  • Kyung-Jae Park
    • 2
  • Yoshio Arai
    • 1
  • John C. Flickinger
    • 1
  • L. Dade Lunsford
    • 1
  1. 1.Department of Neurological Surgery and Radiation OncologyUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of Neurosurgery, College of MedicineKorea UniversitySeoulSouth Korea
  3. 3.Department of Neurological SurgeryUniversity of PittsburghPittsburghUSA

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