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Effect of high-dose delivery on the attachment of meningiomas in Gamma Knife surgery: a retrospective study

  • Original Article - Tumor - Meningioma
  • Published:
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Abstract

Background

Meningiomas have vascular supply from the tumor attachment on the dura mater. Gamma Knife radiosurgery (GKS) is known to have a vascular obliterating effect. This study aims to determine the benefits of high-dose irradiation to the tumor attachment compared to conventional dose planning in the long-term control of tumor growth with GKS.

Methods

Two different dose plannings were retrospectively compared in 75 patients with meningioma treated with GKS as a primary treatment. Forty-three patients were irradiated over 20 Gy to the tumor attachment. The remaining 32 patients were treated with conventional-dose planning. Tumor growth control, reduction of enhancement on the gadolinium-enhanced magnetic resonance imaging (MRI), and neurological status were retrospectively assessed.

Results

The maximum dose on the tumor attachment was significantly higher in the high-dose group (23 Gy) than in the conventional group (16 Gy). The tumor margin was irradiated with the median of the 50% isodose line in both groups. The prescription doses resulted in 14 Gy and 12 Gy, respectively. The tumor control rate achieved 91% in both groups during the median follow-up period of 54 months. A decrease of enhancement on follow-up MRI was noted in one patient in each group. Kaplan–Meier analysis revealed no statistical difference in the progression-free survival between the two groups. The number of patients with improved neurological status showed no statistical difference.

Conclusions

No obvious benefit of high-dose irradiation to the tumor attachment and margin was found in tumor control and neurological status in the long term.

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Data availability

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

We thank Ms. Satomi Fujimura and Ms. Yasuko Noda for the assistance with data collection.

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Authors and Affiliations

  1. Department of Neurosurgery, Koto Memorial Hospital, 2-1 Hiramatsu-cho, Higashiohmi-shi, Shiga, 527-0134, Japan

    Takuro Inoue, Yukihiro Goto, Ayako Shima, Hisao Hirai, Satoshi Shitara, Fumio Suzuki & Masayuki Matsuda

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  1. Takuro Inoue
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  2. Yukihiro Goto
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  3. Ayako Shima
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  4. Hisao Hirai
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  5. Satoshi Shitara
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  6. Fumio Suzuki
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  7. Masayuki Matsuda
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Contributions

Conception and design: Inoue. Drafting of the article: Inoue and Goto. Treating the patients: Inoue, Shima, and Hirai. Analyzing the data: Inoue, Shima, and Shitara. Figures: Inoue and Shima. Critically revising the article: Matsuda and Suzuki.

Corresponding author

Correspondence to Takuro Inoue.

Ethics declarations

Statement of Ethics

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional committee and national research committee. This study is in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants in this study. All data identifying the patients were anonymized. This study protocol was reviewed and approved by the ethics committee of Koto Memorial Hospital (Shiga, Japan), approval number 2012–12.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Inoue, T., Goto, Y., Shima, A. et al. Effect of high-dose delivery on the attachment of meningiomas in Gamma Knife surgery: a retrospective study. Acta Neurochir 164, 2465–2471 (2022). https://doi.org/10.1007/s00701-022-05291-x

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  • DOI: https://doi.org/10.1007/s00701-022-05291-x

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