Gamma Knife Radiosurgery in Sphenopetroclivalmeningiomas:PreliminaryExperience at Iran Gamma Knife Center.

Gamma Knife Radiosurgery in Sphenopetroclivalmeningiomas:PreliminaryExperience at Iran Gamma Knife Center.

World Neurosurg. 2016 Jun 1;

Authors: Azar M, Kazemia F, Chanideh I, Amirjamshidi A, Amini E, Ghanavati P

Abstract
OBJECTIVE: The aims of this study were to characterize the epidemiological, histological, and radiological aspects of sphenopetroclival meningiomas (SpPCMs), and to evaluate the outcome of Gamma Knife radiosurgery (GKRS) either as an adjunct to microsurgery or as a primary SpPCM treatment modality.
METHODS: In this retrospective study, medical records of patients with SpPCM who underwent GKRS at the Iran Gamma Knife Center between April 2003 and March 2012 were analyzed.
RESULTS: We assessed 122 patients with SpPCMs, including 101 women and 21 men, aged 24-94 years. The mean tumor volume was 12.24 ± 9.30 mL. Patients received 22.32 ± 3.29 Gy and 13.18 ± 1.02 Gy maximal and average marginal dose of GKRS, respectively. The most common complaint was visual impairment, followed by facial sensory impairment and headache. The most frequently involved cranial nerves were III, IV, and VI in 72.1% of patients, followed by II in 52.9%, and V in 35.5%. Following radiosurgery, headaches improved in 90.0%, diplopia in 75.0%, and ptosis in 63.0% of patients. On magnetic resonance imaging, tumor size was reduced, unchanged, or increased in 77, 44, and 1 patient, respectively. Progression-free survival at the 5-year follow-up was 56.6%. Lower age (hazard ratio [HR] = 0.972, P = 0.011) and lower tumor volume (HR = 0.959, P = 0.009) were the main prognostic factors for progression-free survival.
CONCLUSION: GKRS can be an effective alternative treatment for controlling SpPCM tumor progression, producing appropriate clinical outcomes and few complications.

PMID: 27262654 [PubMed - as supplied by publisher]

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