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Hypofractionated stereotactic radiosurgery for large-sized skull base meningiomas

  • Clinical Study
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Abstract

Purpose

Although stereotactic radiosurgery (SRS) has been proven to be effective and safe for treating intracranial meningiomas, concerns have been raised about the use of SRS for large-sized tumors involving the skull base that frequently encroach onto adjacent critical neural structures. The purpose of this study was to investigate the role of hypofractionated SRS as a therapeutic option for large-sized skull base meningiomas.

Methods

Thirty-one consecutive patients (median age: 55 years, 9 men and 22 women) who had been treated with hypofractionated SRS using CyberKnife for large-sized skull base meningiomas (> 10 cm3 in volume, median of 18.9 cm3, range 11.6–58.2 cm3) were enrolled. All patients harbored middle or posterior skull base tumors, most frequently of cavernous sinus (n = 7, 22.6%), petroclival (n = 6, 19.4%), or tentorial edge (n = 6, 19.4%) locations. SRS was delivered in five daily fractions (range 3–5 fractions) with a median cumulative dose of 27.8 Gy (range 22.6–27.8 Gy).

Results

With a median follow-up of 57 months (range 9–98 months), tumor control was achieved for 28 (90.3%) of 31 patients. Treatment response on MRI included partial response (volume decrease > 20%) in 17 (54.8%) patients, stable in 11 (35.5%), and progression (volume increase > 20%) in 3 (9.7%). Of 21 patients with cranial neuropathy, 20 (95.2%) showed improved neurological status.

Conclusions

Our current results suggest a promising role of hypofractionated SRS for large-sized skull base megningiomas in terms of tumor control and neurological outcomes. It is a reasonable therapeutic option for select patients.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by Soonchunhyang University Research Fund.

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Authors and Affiliations

  1. Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea

    Hyuk-Jin Oh

  2. Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Young Hyun Cho, Jeong Hoon Kim, Chang Jin Kim & Do Hoon Kwon

  3. Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Young Hyun Cho, Chang Jin Kim, Do Hoon Kwon, Doheui Lee & KyoungJun Yoon

Authors
  1. Hyuk-Jin Oh
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  2. Young Hyun Cho
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  4. Chang Jin Kim
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Correspondence to Young Hyun Cho.

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The authors declare that they have no conflict of interest.

Ethical approval

The Human Investigation Committee (IRB) of University of Ulsan approved this study (S2018-1981-0001). All procedures performed in this study involving human participants were in accordance with ethical standards of the institutional and/or national research committee. They were also in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent was not required.

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Oh, HJ., Cho, Y.H., Kim, J.H. et al. Hypofractionated stereotactic radiosurgery for large-sized skull base meningiomas. J Neurooncol 149, 87–93 (2020). https://doi.org/10.1007/s11060-020-03575-9

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  • DOI: https://doi.org/10.1007/s11060-020-03575-9

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