Skip to main content
SpringerLink
Log in

Gamma Knife Radiosurgery of Skull Base Meningiomas

  • Conference paper
Gamma Knife Radiosurgery

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 91))

Summary

Meningiomas are the most frequent benign tumors treated by gamma knife radio surgery and the majority of them are located on the skull base. Between 1992 and 1999, 197 skull base-located meningiomas in 192 patients were treated by gamma knife in Prague. Contact with the chiasma or optic tract was not regarded as a contra-indication for gamma knife radi osurgery and such contact was observed in 32% of the skull base meningiomas treated. 176 patients were monitored during a median of 36 months, of whom 73% showed a decrease in tumor volume; no change was observed in 25% and continued growth was observed in 2%. Neurodeficit improved in 63% of pat ient s, tempor ary morbidity occurred in 11% and persistent morbidity remained in 4.5%. Radiosurgery induced edema in 11%. Significantly lower edema occurrence was observed after radiosurgery in patients with no history of edema prior to radiosurgery, where the tumor was located in the posterior skull base and where the dosage to the tumor margin was lower than or equal to 14 Gy. Radiosurg ery of skull base meningiomas has been proven to be safe and efficient. We consider gamma knife treatment for skull base meningiomas to be the method of choice whenever tumors are within the volume limits and there is no need for an urgent decompressive effect from the open operation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Aichholzer M. Bertalanffy A. Dietrich W et al (2000) Gamma knife radiosurgery of skull base meningiomas. Acta Neurochir (Wien) 142: 647–653

    Article  CAS  Google Scholar 

  2. Al-Mefty O (1990) Clinoidal meningiomas. J Neurosurg 73: 840–849

    Article  PubMed  CAS  Google Scholar 

  3. Arai H. Sato K. Okudaet K. et al (2000) Transcranial transsphenoidal approach for tuberculum sellae meningiomas. Acta Neurochir (Wien) 142: 751–757

    Article  CAS  Google Scholar 

  4. Brada M. Ford D. Ashley S et al (1992) Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma. BMJ 304(6838): 1343–1346

    Article  PubMed  CAS  Google Scholar 

  5. Ciric I. Landau B (1993) yTentorial and posterior cranial fossa meningiomas: operative results and long-term follow-up: experience with twenty-six cases. Surg Neurol 39(6): 530–537

    Article  PubMed  CAS  Google Scholar 

  6. De Jesus O, Sekhar LN, Parikh HK. Wright DC, Wagner DP (1996) Long-term follow up of patients with meningiomas involving the cavernous sinus: recurrence, progression, and quality of life. Neurosurgery 39: 915–920

    Article  PubMed  Google Scholar 

  7. DeMonte F, Smith HK, Al-Mefty O (1994) Outcome of aggressive removal of cavernous sinus meningiomas. J Neurosurg 81(2): 245–251

    Article  PubMed  CAS  Google Scholar 

  8. DeMonte F, Marmor E, AI-Mefty O (2001) Meningiomas. In: Kaye AH, Laws ER Jr (eds) Brain tumors. Churchill livingstone, London. pp 719–750

    Google Scholar 

  9. Duma CM, Lunsford LD, Kondziolka D, Harsh IV GR, Flickinger JC (1993) Stereotactic radiosurgery of cavernous sinus meningiomas as an addition or alternative to microsurgery. Neurosurgery 32(5): 699–705

    Article  PubMed  CAS  Google Scholar 

  10. Flickingeric JC, Lunsford LD, Kondziolka D (1992) Dose prescription and dose volume effects in radiosurgery. Neurosurg Clin North Am 3(1): 1–59

    Google Scholar 

  11. Ganz JC, Schrollner O. Pendl G (1996) Radiation-induced edema after gamma knife treatment for meningioma. Stereotact Funct Neurosurg 66(Suppl]1: 129–133

    Article  PubMed  Google Scholar 

  12. Glaholm J, Bloom HJ, Crow JH (1990) The role of radiotherapy in the management of intracranial meningiomas. Int J Radiat Oncol Biol Phys 18(4): 755–761

    Article  PubMed  CAS  Google Scholar 

  13. Goldsmith BJ, Want WM, Wilson ChB, Larson DA (1994) Postoperative irradiation for subtotally resected meningiomas. J Neurosurg 80: 192–201

    Google Scholar 

  14. Hakim R, Alexander III E, Loefller JS et al (1998) Results of linear accelerator-based radiosurgery for intracranial meningiomas. Neurosurgery 42: 446–454

    Article  PubMed  CAS  Google Scholar 

  15. Harrigan MR (2003) Angiogenic factors in the central nervous system. Neurosurgery 53: 639–661

    Article  PubMed  Google Scholar 

  16. Harrison MJ, Wolfe DE, Lau TS, Mitnick RJ, Sachdev VP (1991) Radiation induced meningiomas: experience at the Mount Sinai Hospital and review of the literature. J Neurosurg 75(4): 564–574

    Article  PubMed  CAS  Google Scholar 

  17. Honeybul S, Neil-Dwyer G, Lang DA, Evans BT, Ellison DW (2001) Sphenoid wing meningiomaen plaque: a clinical review. Acta Neurochir (Wien) 143(8): 749–758

    Article  CAS  Google Scholar 

  18. Iwai Y, Yamanaka K, Ishiguro T (2003) Gamma knife radiosurgery for the treatment of cavernous sinus meningiomas. Neurosurgery 52: 517–524

    Article  PubMed  Google Scholar 

  19. Joiner MC (1993) The linear-quadratic approach to fractionation. In: Steel GG (ed) Basic clinical radiobiology for radiation oncologist. Edward Arnold Publishers London

    Google Scholar 

  20. Kim DK, Grieve J, Archer DJ, Uttley D (1996) Meningiomas in the region of the cavernous sinus: a review of 21 patients. Br J Neurosurg 10(5): 439–444

    Article  PubMed  CAS  Google Scholar 

  21. Kleinpeter G, Bock F (1990) Invasion of the cavernous sinus by medial sphenoid meningioma-“radical” surgery and recurrence. Acta Neurochir (Wien) 103(3–4): 87–91

    Article  CAS  Google Scholar 

  22. Kurita H, Sasaki T, Kawamoto S et al (1997) Role of radiosurgery in the management of cavernous sinus meningiomas. Acta Neurol Scand 96(5): 297–304

    Article  PubMed  CAS  Google Scholar 

  23. Lang DA, Neil-Dwyer G, Garfield J (1999) Outcome after complex neurosurgery: the caregiver’s burden is forgotten. J Neurosurg 91: 359–363

    Article  PubMed  CAS  Google Scholar 

  24. Larson DA, Flickinger JC, Loefler JS (1993) The radiobiology of radiosurgery. Int J Radiation Oncology Biol Phys 2: 557–561

    Article  Google Scholar 

  25. Leber KA, Bergloff J, Pendl G (1998) Dose response tolerance of the visual pathways and cranial nerves of the cavernous sinus to stereotactic radiosurgery. J Neurosurg 88: 43–50

    Article  PubMed  CAS  Google Scholar 

  26. Leksell L (1951) The stereotactic method and radiosurgery of the brain. Acta Chir Scand 102: 316–319

    PubMed  CAS  Google Scholar 

  27. Linskey ME (2000) Stereotactic radiosurgery versus stereotactic radiotherapy for patients with vestibular schwannoma: a Leksell gamma knife society 2000 debate. J Neurosurg [Suppl] 3(93): 90–95

    Google Scholar 

  28. Liscak R, Vladyka V, Simonova G, Novotny JJr, Syrucek M (1998) Gamma-knife radiosurgery of meningiomas preliminary results and complications. J Radiosurgery 1: 35–42

    Article  Google Scholar 

  29. Liscak R, Simonova G, Vymazal J, Janouskova L, Vladyka V (1999) Gamma knife radiosurgery of meningiomas in the cavernous sinus region. Acta Neurochir (Wien) 141: 473–480

    Article  CAS  Google Scholar 

  30. Lunsford LD (1994) Contemporary management of meningiomas: radiation therapy as an adjuvant and radiosurgery as an alternative to surgical removal? J Neurosurg 80: 187–190

    Article  PubMed  CAS  Google Scholar 

  31. Mathiesen T, Lindquist C, Kihlstrom L, Karlsson B (1996) Recurrence of cranial base meningiomas. Neurosurgery 39: 2–9

    Article  PubMed  CAS  Google Scholar 

  32. Mathiesen T, Kihlstrom T, Karlsson B, Lindquist Ch (2003) Potential complications following radiotherapy for meningiomas. Surg Neurol 60: 193–200

    Article  PubMed  Google Scholar 

  33. Miralbell R, Linggood RM, de la Monte S, Convery K, Munzenrider JE, Mirimanoff RO (1992) The role of radiotherapy in the treatment of subtotally resected benign meningiomas. J Neurooncol 13(2): 157-164

    Article  PubMed  CAS  Google Scholar 

  34. Nicolato A, Foroni R, Alessandrini F, Bricolo A, Gerosa M (2002) Radiosurgical treatment of cavernous sinus meningiomas” experience with 122 treated patients. Neurosurgery 51: 1153–1161

    Article  PubMed  Google Scholar 

  35. Niiro M, Yatsushiro K, Nakamura K, Kwahara Y, Kuratsu J (2000) Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatry 68: 25–28

    Article  PubMed  CAS  Google Scholar 

  36. Novotny J Jr, Novotny J, Vymazal J et al (1998) Assessment of the accuracy of stereotactic target localization using magnetic resonance imaging: a phantom study. J Radiosurgery 1: 99–111

    Article  Google Scholar 

  37. Olivero WC, Lister JR, Elwood PW (1995) The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients. J Neurosurg 83: 222–224

    Article  PubMed  CAS  Google Scholar 

  38. O’Sullivan MG, Loveren HR, Tew JM (1997) The surgical resectability of meningiomas of the cavernous sinus. Neurosurgery 40:238–247

    Article  PubMed  Google Scholar 

  39. Pan DH, Guo WY, Chang YC et al (l998) The effectiveness and factors related to treatment results ofgamma knife radiosurgery of meningiomas. Stereotact Funct Neurosurg 70[Suppl]1: 19–32

    Google Scholar 

  40. Pendl G, Schrottner O, Eustacchio S, Feichtinger K, Ganz J (1997) Stereotactic radiosurgery of skull base meningiomas. Minim Invas Neurosurg 40: 87–90

    Article  CAS  Google Scholar 

  41. Roche PH, Regis J, Dufour H et al (2000) Gamma knife radiosurgery in the management of cavernous sinus meningiomas. J Neurosurg 93 [Suppl]3: 68–73

    Article  PubMed  Google Scholar 

  42. Samii M, Tatagiba M (1992) Experience with 36 surgical cases of petroclival meningiomas. Acta Neurochirurg (Wien) 118(12): 27–32

    Article  CAS  Google Scholar 

  43. Samii M, Tatagiba M, Monteiro ML (1996) Meningiomas involving the parasellar region. Acta Neurochir (Wien) [Suppl] 65: 63–65

    CAS  Google Scholar 

  44. Samii M, Carvalho GA, Tatagiba M, Matthies C (1997) Surgical management of meningiomas originating in Meckel’s cave. Neurosurgery 41(4): 767–775

    Article  PubMed  CAS  Google Scholar 

  45. Sekhar LN, Jannetta PJ, Burkhart LE, Janosky JE (1990) Meningiomas involving the clivus: a six-year experience with 41 patients. Neurosurgery 27(5): 764–781

    Article  PubMed  CAS  Google Scholar 

  46. Sekhar LN, Altschuler EM (1991) Meningiomas of the cavernous sinus. In: Al-Mefty O (ed) Meningiomas. Raven Press, New York, pp 445–460

    Google Scholar 

  47. Shin M, Kurita H, Sasaki T et al (2001) Analysis of treatment outcome after stereotactic radiosurgery for cavernous sinus meningiomas. J Neurosurg 95(3): 435–439

    Article  PubMed  CAS  Google Scholar 

  48. Sindou MP, Alaywan M (1998) Most intracranial meningiomas are not cleavable tumors: anatomic-surgical evidence and angiographic predictability. Neurosurgery 42: 476–480

    Article  PubMed  CAS  Google Scholar 

  49. Steiner L, Prasad D, Lindquist Ch, Steiner M (1997) Clinical aspects of gamma knife stereotactic radiosurgery. In: Gildenberg P, Tasker R (eds) Textbook of stereotactic and functional neurosurgery. McGraw-Hill, New York, pp 772–774

    Google Scholar 

  50. Subach BR, Lunsford LD, Kondziolka D. Maitz AH, Flickinger JC (1998) Management of petroclival meningiomas by stereotactic radiosurgery. Neurosurgery 42(3): 437–445

    Article  PubMed  CAS  Google Scholar 

  51. Tamiya T, Ono Y, Matsumoto K, Ohmoto T (2001) Peritumoral brain edema in intracranial meningiomas: effects of radiological and histological factors. Neurosurgery 49: 1046–1052

    PubMed  CAS  Google Scholar 

  52. Tanaka T, Kobayashi T, Kida Z (1996) Growth control of cranial base meningiomas by stereotactic radiosurgery with a Leksell Gamma Knife unit. Neurol Med Chir 36(1): 7–10

    Article  CAS  Google Scholar 

  53. Tishler RB, Loeffler JS, Lunsford LD et al (1993) Tolerance of cranial nerves of the cavernous sinus to radiosurgery. Int J Radiation Oncology Biol Phys 27: 215–221

    Article  CAS  Google Scholar 

  54. Van Havenbergh T, Carvalho G, Tatagiba M, Plets Ch, Samii M (2003) Natural history of petroclival meningiomas. Neurosurgery 52: 55–64

    PubMed  Google Scholar 

  55. Wilson BC (1994) Meningiomas: genetics, malignancy, and the role of radiation in induction and treatment. J Neurosurg 81: 666–675

    Article  PubMed  CAS  Google Scholar 

  56. Yamashita J. Handa H, Iwaki K, Abe M (1980) Recurrence of intracranial meningiomas, with special reference to radiotherapy. Surg Neurol 14: 33–40

    PubMed  CAS  Google Scholar 

  57. Yasargil MG (1996) Microneurosurgery of CNS tumors. Georg Thieme Verlag, New York, pp 134–185

    Google Scholar 

  58. Yoneoka Y, Fujii Y, Tanaka R (2000) Growth of incidental meningiomas. Acta Neurochir (Wien) 42: 507–511

    Article  Google Scholar 

  59. Zentner J, Meyer B, Vieweg U, Herberhold C, Schramm J (1997) Petroclival meningiomas: is radical resection always the best option? J Neurol Neurosurg Psychiatry 62(4): 341–345

    Article  PubMed  CAS  Google Scholar 

  60. Zevgaridis O, Medele RJ, Muller A, Hischa AC, Steiger HJ (2001) Meningiomas of the sellar region presenting with visual impairment: impact of various prognostic factors on surgical outcome in 62 patients. Acta Neurochir (Wien) 143(5): 471–476

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic

    R. Liščák M.D., Ph.D., A. Kollová, V. Vladyka, G. Šimonová & J. Novotný Jr

  2. Department of Neurosurgery, III. Faculty of Medicine, Charles University, Prague, Czech Republic

    R. Liščák M.D., Ph.D.

Authors
  1. R. Liščák M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Kollová
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Vladyka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Šimonová
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Novotný Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Liščák M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. German Gamma Knife Centre, Munich, Germany

    B. Wowra  & A. Muacevic  & 

  2. Neurochirurgische Klinik und Poliklinik, Klinikum Großhadern, Munich, Germany

    J.-C. Tonn

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Wien

About this paper

Cite this paper

Liščák, R., Kollová, A., Vladyka, V., Šimonová, G., Novotný, J. (2004). Gamma Knife Radiosurgery of Skull Base Meningiomas. In: Wowra, B., Muacevic, A., Tonn, JC. (eds) Gamma Knife Radiosurgery. Acta Neurochirurgica Supplements, vol 91. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0583-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0583-2_7

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7200-1

  • Online ISBN: 978-3-7091-0583-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation