Gamma Knife Radiosurgery of Meningiomas in the Cavernous Sinus Region

Summary

 For 6 years (1992–1998) we have treated 67 patients with cavernous sinus meningioma using the Leksell gamma knife in the Hospital Na Homolce, Prague. The age of the patients ranged between 19–82 years, median 57 years. Radiosurgery was the primary treatment in 64,2% of the patients, in the rest a microsurgical resection preceded. The volume of the tumour ranged from 0,9–31,4 cm³, median 7,8 cm³. The meningioma was distant from the optic tract in 58% of the cases, in 12% of the cases there was a contact with the tumour and the optic tract without its compression and in 30% of the cases there was a compression of the optic tract caused by the meningioma. The dose to the tumour margin ranged from 10–14 Gy, median 12 Gy. The follow up was available in 53 patients, in intervals of 2–60 months, median 19 months. There was no change in the tumour volume in 48% of the cases, in 52% of the cases a decrease of the tumour volume occurred. No increase of the tumour volume was observed. Clinical symptoms and signs improved in 35,8% of the patients, temporary morbidity was 3,8%. The mortality of the treatment was zero.

 Hitherto, the results of gamma knife radiosurgery of cavernous sinus meningioma have proved its safety and efficiency, although long term experience with a large group of patients is missing. Advances in neuroradiology and radiosurgical technique have allowed us to treat tumours with a closer contact to the optic tract and nerves compared with the past.