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Stereotactic Radiosurgery for Benign Cavernous Sinus Meningiomas: A Multicentre Study and Review of the Literature
A. Santacroce, C. Tuleasca, R. Liščák, E. Motti, C. Lindquist, M. Radatz, B. Gatterbauer, BE. Lippitz, R. Martínez Álvarez, N. Martínez Moreno, MA. Kamp, B. Sandvei Skeie, S. Schipmann, M. Longhi, F. Unger, I. Sabin, T. Mindermann, O. Bundschuh,...
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
Grantová podpora
75-6075
Elekta Instrument AB
NLK
Free Medical Journals
od 2009
PubMed Central
od 2009
Europe PubMed Central
od 2009
ProQuest Central
od 2009-01-01
Open Access Digital Library
od 2009-01-01
Open Access Digital Library
od 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2009
PubMed
36011041
DOI
10.3390/cancers14164047
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
Cavernous sinus meningiomas (CSMs) remain a surgical challenge due to the intimate involvement of their contained nerves and blood vessels. Stereotactic radiosurgery (SRS) is a safe and effective minimally invasive alternative for the treatment of small- to medium-sized CSMs. Objective: To assess the medium- to long-term outcomes of SRS for CSMs with respect to tumour growth, prevention of further neurological deterioration and improvement of existing neurological deficits. This multicentric study included data from 15 European institutions. We performed a retrospective observational analysis of 1222 consecutive patients harbouring 1272 benign CSMs. All were treated with Gamma Knife stereotactic radiosurgery (SRS). Clinical and imaging data were retrieved from each centre and entered into a common database. All tumours with imaging follow-up of less than 24 months were excluded. Detailed results from 945 meningiomas (86%) were then analysed. Clinical neurological outcomes were available for 1042 patients (85%). Median imaging follow-up was 67 months (mean 73.4, range 24-233). Median tumour volume was 6.2 cc (+/-7), and the median marginal dose was 14 Gy (+/-3). The post-treatment tumour volume decreased in 549 (58.1%), remained stable in 336 (35.6%) and increased in only 60 lesions (6.3%), yielding a local tumour control rate of 93.7%. Only 27 (2.8%) of the 60 enlarging tumours required further treatment. Five- and ten-year actuarial progression-free survival (PFS) rates were 96.7% and 90.1%, respectively. Tumour control rates were higher for women than men (p = 0.0031), and also for solitary sporadic meningiomas (p = 0.0201). There was no statistically significant difference in outcome for imaging-defined meningiomas when compared with histologically proven WHO Grade-I meningiomas (p = 0.1212). Median clinical follow up was 61 months (mean 64, range 6-233). Permanent morbidity occurred in 5.9% of cases at last follow-up. Stereotactic radiosurgery is a safe and effective method for treating benign CSM in the medium term to long term.
Department of Medicine Faculty of Health Witten Herdecke University 58455 Witten Germany
Department of Neurosurgery Academic Hospital Köln Merheim 51058 Köln Germany
Department of Neurosurgery Haukeland University Hospital 5021 Bergen Norway
Department of Neurosurgery Heinrich Heine Universität Düsseldorf 40225 Düsseldorf Germany
Department of Neurosurgery Medical University Graz 8036 Graz Austria
Department of Neurosurgery Medical University of Vienna 1090 Vienna Austria
Department of Neurosurgery St Barbara Klinik Hamm Heessen 59073 Hamm Germany
Department of Radiosurgery Rúber International Hospital 28034 Madrid Spain
Dipartimento di Neuroscienze Neurochirurgia Università degli Studi di Milano 20122 Milano Italy
Faculté de Biologie et de Médecine 1005 Lausanne Switzerland
Faculté de Médecine Sorbonné Université 70513 Paris France
Gamma Knife Center Zurich Klinik Im Park Hirslanden 8002 Zurich Switzerland
Gamma Knife Centre Bupa Cromwell Hospital London SW5 0TU UK
Gamma Knife Unit Wellington Hospital London NW8 7JA UK
Gamma Knife Zentrum Hannover 30167 Hannover Germany
Gamma Knife Zentrum Krefeld 47805 Krefeld Germany
Interdisciplinary Centre for Radiosurgery Radiological Alliance 22767 Hamburg Germany
National Centre for Stereotactic Radiosurgery Royal Hallamshire Hospital Sheffield S10 2JF UK
Neurosurgery Service and Gamma Knife Center Lausanne University Hospital 1011 Lausanne Switzerland
Citace poskytuje Crossref.org
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- $a Cavernous sinus meningiomas (CSMs) remain a surgical challenge due to the intimate involvement of their contained nerves and blood vessels. Stereotactic radiosurgery (SRS) is a safe and effective minimally invasive alternative for the treatment of small- to medium-sized CSMs. Objective: To assess the medium- to long-term outcomes of SRS for CSMs with respect to tumour growth, prevention of further neurological deterioration and improvement of existing neurological deficits. This multicentric study included data from 15 European institutions. We performed a retrospective observational analysis of 1222 consecutive patients harbouring 1272 benign CSMs. All were treated with Gamma Knife stereotactic radiosurgery (SRS). Clinical and imaging data were retrieved from each centre and entered into a common database. All tumours with imaging follow-up of less than 24 months were excluded. Detailed results from 945 meningiomas (86%) were then analysed. Clinical neurological outcomes were available for 1042 patients (85%). Median imaging follow-up was 67 months (mean 73.4, range 24-233). Median tumour volume was 6.2 cc (+/-7), and the median marginal dose was 14 Gy (+/-3). The post-treatment tumour volume decreased in 549 (58.1%), remained stable in 336 (35.6%) and increased in only 60 lesions (6.3%), yielding a local tumour control rate of 93.7%. Only 27 (2.8%) of the 60 enlarging tumours required further treatment. Five- and ten-year actuarial progression-free survival (PFS) rates were 96.7% and 90.1%, respectively. Tumour control rates were higher for women than men (p = 0.0031), and also for solitary sporadic meningiomas (p = 0.0201). There was no statistically significant difference in outcome for imaging-defined meningiomas when compared with histologically proven WHO Grade-I meningiomas (p = 0.1212). Median clinical follow up was 61 months (mean 64, range 6-233). Permanent morbidity occurred in 5.9% of cases at last follow-up. Stereotactic radiosurgery is a safe and effective method for treating benign CSM in the medium term to long term.
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