• El-ShehabyAmr M NAMNGamma Knife Center Cairo, Nasser Institute for Research and Treatment, Cairo, Egypt; Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: amrelshehaby@yahoo.com., Wael A Reda, Khaled M Abdel Karim, Ahmed M Nabeel, Reem M Emad Eldin, and Sameh R Tawadros.
• Gamma Knife Center Cairo, Nasser Institute for Research and Treatment, Cairo, Egypt; Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: amrelshehaby@yahoo.com.
• World Neurosurg. 2021 Jun 1; 150: e324-e336.

BackgroundThe use of stereotactic radiosurgery for the treatment of intracranial meningiomas has been established as an effective and safe treatment modality. Larger meningiomas typically are managed by surgery followed by radiosurgery. Treatment of large meningiomas (usually defined as >10 cc) by stereotactic radiosurgery has been investigated in some recent reports, either by single-session, volume-staged, or the hypofractionation technique. We sought to assess the long-term efficacy and safety of single-session stereotactic radiosurgery for large (10 cc or more) intracranial benign meningiomas.Patients And MethodsIn this retrospective study, we included 273 patients with large benign meningiomas (≥10 cc) who were treated by single-session SRS and followed up for more than 2 years. Tumors were in a basal location in 228 patients (84%). There were 161 tumors (59%) in the perioptic location. The median tumor volume was 15.5 (10-57.3 cc [interquartile range {IQR} 12.3 cc]). The median prescription dose was 12 Gy (9-15 Gy [IQR 1 Gy]).ResultsThe median follow-up period was 6.1 years (2-18 years [IQR 5.5 years]). The tumor control rate was 90%. The progression-free survival at 5 and 10 years was 96% and 81%, respectively, for the whole cohort. Among 161 patients with perioptic meningiomas, favorable (better/stable) visual outcome was reported in 155 patients (96%) and unfavorable (worse) outcome in 6 patients (4%). Temporary adverse radiation effects were observed in 41 patients (15%) but only 16 (6%) were symptomatic.ConclusionsStereotactic radiosurgery provides an effective and safe treatment option for large meningiomas.Copyright © 2021 Elsevier Inc. All rights reserved.

39 keywords...

hide…