Skip to main content
SpringerLink
Log in

Stereotactic radiosurgery for atypical and anaplastic meningiomas

  • Original Paper
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Atypical and anaplastic meningiomas frequently recur in the relatively short-term after surgery. We have followed such postoperative cases by short-interval repeated MRI and have performed stereotactic radiosurgery (SRS) for progressive tumors as a salvage therapy. The objective of this report was assessment of the degree of tumor control, the risk of complications, and the presence of variables that predict outcome in patients treated with SRS for high-grade meningiomas. We reviewed 12 high-grade meningioma patients with 30 lesions treated by Linac-based SRS at Kyoto University Hospital between 1997 and 2002. They included 10 atypical meningiomas and 2 anaplastic ones according to the WHO classification. A mean tumor volume was 4.40cc and a mean marginal dose of SRS was 18.0 Gy (12–20 Gy). After a mean follow-up period of 43.4 months (6–84 months), 13 lesions had progression tumor within the SRS field and 6 lesions had out of the SRS field. Nine of 14 lesions, which were treated by SRS with a marginal dose of less than 20 Gy, had local recurrence in the SRS field. In contrast, four of 16 lesions, which were treated with marginal dose of 20 Gy, had local recurrence in the SRS field. The marginal dose <20 Gy was a statistically significant factor for a short-term progression in high-grade meningiomas (P = 0.0139). Five-year progression-free survival ratio in lesions treated with SRS below 20 Gy and 20 Gy were 29.4% and 63.1%, respectively. In conclusion, based on our findings, we suggest that recurrent high-grade meningiomas be treated by SRS with a marginal dose exceeding 20 Gy.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Louis DN, Scheithauer BW, Budka H, von Deimlig A, Kepes JJ (2000) Pathology and genetics of tumours of the nervous system; World Health Organisation Classification of Tumours. Lyon: IARC Press, 176–184

    Google Scholar 

  2. Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL (1985) Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62:18–24

    PubMed  CAS  Google Scholar 

  3. Condra KS, Buatti JM, Mendenhall WM, Friedman WA, Marcus RB Jr, Rhoton AL (1997) Benign meningiomas: primary treatment selection affects survival. Int J Radiat Oncol Biol Phys 39:427–436

    Article  PubMed  CAS  Google Scholar 

  4. Hoffmann W, Muhleisen H, Hess CF, Kortmann RD, Schmidt B, Grote EH, Bamberg M (1995) Atypical and anaplastic meningiomas—Does the new WHO-classification of brain tumours affect the indication for postoperative irradiation? Acta Neurochir (Wien) 135:171–178

    Article  CAS  Google Scholar 

  5. Taylor BW Jr, Marcus RB Jr, Friedman WA, Ballinger WE Jr, Million RR (1988) The meningioma controversy: Postoperative radiation therapy. Int J Radiat Oncol Biol Phys 15:299–304

    Article  PubMed  Google Scholar 

  6. Engenhart R, Kimmig BN, Hover KH, Wowra B, Sturn V, van Kaick G, Wannenmacher M (1990) Stereotactic single high dose radiation therapy of benign intracranial meningiomas. Int J Radiat Oncol Biol Phys 19:1021–6

    PubMed  CAS  Google Scholar 

  7. Kondziolka D, Flickinger JC, Perez B (1998) Judicious resection and/or radiosurgery for parasagittal meningiomas: Outcomes from a multicenter review. Gamma Knife Meningioma Study Group. Neurosurg 43:405–413

    Article  CAS  Google Scholar 

  8. Kondziolka D, Levy EI, Niranjan A, Flickinger JC, Lunsford LD (1999) Long-term outcomes after meningioma radiosurgery: physician and patient perspectives. J Neurosurg 91:44–50

    PubMed  CAS  Google Scholar 

  9. Jaaskelainen J, Haltia M, Servo A (1986) Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol 25:233–242

    Article  PubMed  CAS  Google Scholar 

  10. Stafford SL, Pollock BE, Foote RL, Link MJ, Gordon DA, Schomberg PJ, Leavitt JA (2001) Meningioma radiosurgery: tumor control, outcomes, and complications among 190 patients. Neurosurg 49(5):1029–1038

    Article  CAS  Google Scholar 

  11. Palma L, Celli P, Franco C, Cantore G (1997) Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg 86:793–800

    Article  PubMed  CAS  Google Scholar 

  12. Kondziolka D, Lunsford LD, Coffey RJ, Flickinger JC (1991) Gamma knife radiosurgery of meningiomas. Stereotact Funct Neurosurg 57:11–21

    Article  PubMed  CAS  Google Scholar 

  13. Perry A, Scheithauer BW, Stafford SL, Lohse CM, Wollan PC (1999) “Malignancy” in meningiomas: a clinicopathologic study of 116 patients. Cancer 85:2046–2056

    PubMed  CAS  Google Scholar 

  14. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc. 53:457–481

    Article  Google Scholar 

  15. Goldsmith BJ, Wara WM, Wilson CB, Larson DA (1994) Postoperative irradiation for subtotally resected meningiomas. A retrospective analysis of 140 patients treated from 1967 to 1990. J Neurosurg 80:195–201

    Article  PubMed  CAS  Google Scholar 

  16. Goyal LK, Suh JH, Mohan DS, Prayson RA, Lee J, Barnett GH (2000) Local control and overall survival in atypical meningioma: a retrospective study. Int J Radiat Oncol Biol Phys 46:57–61

    Article  PubMed  CAS  Google Scholar 

  17. Ojemann SG, Sneed PK, Larson DA, Gutin PH, Berger MS, Verhey L, Smith V, Petti P, Wara W, Park E, McDermott MW (2000) Radiosurgery for malignant meningioma: results in 22 patients. J Neurosurg 93(Suppl 3):62–67

    PubMed  Google Scholar 

  18. Milosevic MF, Frost PJ, Laperriere NJ, Wong CS, Simpson WJ (1996) Radiotherapy for atypical or malignant intracranial meningioma. Int J Radiat Oncol Biol Phys 34:817–822

    Article  PubMed  CAS  Google Scholar 

  19. Hakim R, Alexander E III, Loeffler JS, Shrieve DC, Wen P, Fallon MP, Stieg PE, Black PM (1998) Results of linear accelerator-based radiosurgery for intracranial meningiomas. Neurosurg 42:446–453

    Article  CAS  Google Scholar 

  20. Harris AE, Lee JY, Omalu B, Flickinger JC, Kondziolka D, Lunsford LD (2003) The effect of radiosurgery during management of aggressive meningiomas. Surg Neurol 60:298–305

    Article  PubMed  Google Scholar 

  21. Huffmann BC, Reinacher PC, Gilsabach JM (2005) Gamma knife surgery for atypical meningiomas. J Neurosurg 102(Suppl):283–286

    PubMed  Google Scholar 

  22. Katz TS, Amdur RJ, Yachnis AT, Mendenhall WM, Morris CG (2005) Pushing the limits of radiotherapy for atypical and malignant meningioma. Am J Clin Oncol 28:70–74

    Article  PubMed  Google Scholar 

  23. Modha A, Gutin HP. (2005) Diagnosis and treatment of atypical and anaplastic meningiomas: a review. Neurosurgery 57:538–550

    Article  PubMed  Google Scholar 

  24. Shaw E, Scott C, Souhami L, Dinapoli R, Bahary JP, Kline R, Wharam M, Schultz C, Davey P, Loeffler J (1996) Radiosurgery for the treatment of previously irradiated primary brain tumors and brain metastasis: Initial report of Radiation Therapy Oncology Group Protocol 90–05. Int J Radiat Oncol Biol Phys 34:647–654

    Article  PubMed  CAS  Google Scholar 

  25. Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, Farnan N (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: Final report of RTOG protocol 90–05. Int J Radiat Oncol Biol Phys 47:291–298

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Mrs. Ursula Petralia and Mr. BJS Aldrich for critical reading of the manuscript.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Kyoto University Faculty of Medicine, 54 Shyogoin-Kawaharacho, Sakyouku, Kyoto, Japan

    Jun A. Takahashi, Takahisa Katsuki & Nobuo Hashimoto

  2. Department of Neurosurgery, Kishiwada City Hospital, Osaka, Japan

    Hideyuki Kano

  3. Department of Radiation Oncology, Kyoto University Faculty of Medicine, Kyoto, Japan

    Norio Araki & Masahiro Hiraoka

  4. Department of Radiation Oncology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Natsuo Oya

Authors
  1. Hideyuki Kano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun A. Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takahisa Katsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Norio Araki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Natsuo Oya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masahiro Hiraoka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nobuo Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jun A. Takahashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kano, H., Takahashi, J.A., Katsuki, T. et al. Stereotactic radiosurgery for atypical and anaplastic meningiomas. J Neurooncol 84, 41–47 (2007). https://doi.org/10.1007/s11060-007-9338-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-007-9338-y

Keywords

Search

Navigation