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Stereotactic Radiosurgery for Incidentally Discovered Cavernous Sinus Meningiomas: A Multi-institutional Study

S. Pikis, G. Mantziaris, Y. Samanci, S. Peker, AM. Nabeel, WA. Reda, SR. Tawadros, AMN. El-Shehaby, K. Abdelkarim, RM. Emad, CC. Lee, HC. Yang, R. Liscak, J. Hanuska, RM. Alvarez, NM. Moreno, M. Tripathi, H. Speckter, C. Albert, J. Sheehan

. 2022 ; 158 (-) : e675-e680. [pub] 20211114

Language English Country United States

Document type Journal Article, Multicenter Study

Persistent link   https://www.medvik.cz/link/bmc22025471

BACKGROUND: The initial management of asymptomatic, incidentally discovered, cavernous sinus (CS) meningiomas remains incompletely defined. This study evaluated the safety and efficacy of stereotactic radiosurgery (SRS) for patients presenting with an asymptomatic CS meningioma. METHODS: This is an international, retrospective study included patients treated with upfront SRS for an asymptomatic CS meningioma. Local tumor control, tumor and SRS-related complications, and the development of new neurologic deficits after SRS were evaluated. RESULTS: A total of 37 patients (29 men; mean ± SD age: 55.05 ± 11.56 years) treated with upfront SRS for an asymptomatic, CS meningioma were included in the study. The mean ± SD margin dose was 12.27 ± 2.3 Gy. The median clinical and radiological follow-up periods were 66 (IQR 84) and 72 (IQR 84) months, respectively. At the last follow-up, tumor regression and stability were noted in 19 (51.35%) and 18 (48.65%) of CS meningiomas, respectively. SRS-related complications occurred in 2 patients (5.4%) and were managed conservatively. CONCLUSIONS: Upfront SRS is a safe and effective treatment option for asymptomatic CS meningiomas. SRS may be considered at the time of initial diagnosis of a CS meningioma. If observation is the initial management chosen, SRS should be recommended when CS meningioma growth is documented on follow-up imaging.

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$a Pikis, Stylianos $u Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
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$a Stereotactic Radiosurgery for Incidentally Discovered Cavernous Sinus Meningiomas: A Multi-institutional Study / $c S. Pikis, G. Mantziaris, Y. Samanci, S. Peker, AM. Nabeel, WA. Reda, SR. Tawadros, AMN. El-Shehaby, K. Abdelkarim, RM. Emad, CC. Lee, HC. Yang, R. Liscak, J. Hanuska, RM. Alvarez, NM. Moreno, M. Tripathi, H. Speckter, C. Albert, J. Sheehan
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$a BACKGROUND: The initial management of asymptomatic, incidentally discovered, cavernous sinus (CS) meningiomas remains incompletely defined. This study evaluated the safety and efficacy of stereotactic radiosurgery (SRS) for patients presenting with an asymptomatic CS meningioma. METHODS: This is an international, retrospective study included patients treated with upfront SRS for an asymptomatic CS meningioma. Local tumor control, tumor and SRS-related complications, and the development of new neurologic deficits after SRS were evaluated. RESULTS: A total of 37 patients (29 men; mean ± SD age: 55.05 ± 11.56 years) treated with upfront SRS for an asymptomatic, CS meningioma were included in the study. The mean ± SD margin dose was 12.27 ± 2.3 Gy. The median clinical and radiological follow-up periods were 66 (IQR 84) and 72 (IQR 84) months, respectively. At the last follow-up, tumor regression and stability were noted in 19 (51.35%) and 18 (48.65%) of CS meningiomas, respectively. SRS-related complications occurred in 2 patients (5.4%) and were managed conservatively. CONCLUSIONS: Upfront SRS is a safe and effective treatment option for asymptomatic CS meningiomas. SRS may be considered at the time of initial diagnosis of a CS meningioma. If observation is the initial management chosen, SRS should be recommended when CS meningioma growth is documented on follow-up imaging.
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$a Mantziaris, Georgios $u Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
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$a Samanci, Yavuz $u Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
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$a Peker, Selcuk $u Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
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$a Nabeel, Ahmed M $u Gamma Knife Center Cairo-Nasser Institute, Cairo, Egypt; Department of Neurosurgery, Benha University, Benha, Egypt
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$a Reda, Wael A $u Gamma Knife Center Cairo-Nasser Institute, Cairo, Egypt; Department of Neurosurgery, Ain Shams University, Cairo, Egypt
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$a Tawadros, Sameh R $u Gamma Knife Center Cairo-Nasser Institute, Cairo, Egypt; Department of Neurosurgery, Ain Shams University, Cairo, Egypt
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$a El-Shehaby, Amr M N $u Gamma Knife Center Cairo-Nasser Institute, Cairo, Egypt; Department of Neurosurgery, Ain Shams University, Cairo, Egypt
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$a Abdelkarim, Khaled $u Gamma Knife Center Cairo-Nasser Institute, Cairo, Egypt; Department of Neurosurgery, Ain Shams University, Cairo, Egypt
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$a Emad, Reem M $u Gamma Knife Center Cairo-Nasser Institute, Cairo, Egypt; Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
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$a Lee, Cheng-Chia $u Department of Neurosurgery, School of Medicine, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
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$a Yang, Huai-Che $u Department of Neurosurgery, School of Medicine, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
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$a Liscak, Roman $u Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
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$a Hanuska, Jaromir $u Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
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$a Alvarez, Roberto Martinez $u Department of Radiosurgery, Rúber International Hospital, Madrid, Spain
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$a Moreno, Nuria Martinez $u Department of Radiosurgery, Rúber International Hospital, Madrid, Spain
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$a Tripathi, Manjul $u Department of Neurosurgery and Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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$a Speckter, Herwin $u Department of Radiology, Dominican Gamma Knife Center, Santo Domingo, Dominican Republic; CEDIMAT, Santo Domingo, Dominican Republic
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$a Albert, Camilo $u Department of Radiology, Dominican Gamma Knife Center, Santo Domingo, Dominican Republic; CEDIMAT, Santo Domingo, Dominican Republic
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$a Sheehan, Jason $u Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA. Electronic address: jsheehan@virginia.edu
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