Gamma knife surgery of meningiomas involving the cavernous sinus: long-term follow-up of 100 patients.

https://arctichealth.org/en/permalink/ahliterature97633
Source
Neurosurgery. 2010 Apr;66(4):661-8; discussion 668-9
Publication Type
Article
Date
Apr-2010
Author
Bente Sandvei Skeie
P O Enger
G O Skeie
F. Thorsen
P-H Pedersen
Author Affiliation
Department of Neurosurgery, Haukeland University Hospital, N-5021 Bergen, Norway. bsai@helse-bergen.no
Source
Neurosurgery. 2010 Apr;66(4):661-8; discussion 668-9
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cavernous Sinus - surgery
Female
Humans
Longitudinal Studies
Male
Meningeal Neoplasms - pathology - surgery
Meningioma - pathology - surgery
Middle Aged
Radiosurgery - methods
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
Abstract
OBJECTIVE: Resection of meningiomas involving the cavernous sinus often is incomplete and associated with considerable morbidity. As a result, an increasing number of patients with such tumors have been treated with gamma knife surgery (GKS). However, few studies have investigated the long-term outcome for this group of patients. METHODS: 100 patients (23 male/77 female) with meningiomas involving the cavernous sinus received GKS at the Department of Neurosurgery at Haukeland University Hospital, Bergen, Norway, between November 1988 and July 2006. They were followed for a mean of 82.0 (range, 0-243) months. Only 2 patients were lost to long-term follow-up. Sixty patients underwent craniotomy before radiosurgery, whereas radiosurgery was the primary treatment for 40 patients. RESULTS: Tumor growth control was achieved in 84.0% of patients. Twelve patients required re-treatment: craniotomy (7), radiosurgery (1), or both (4). Three out of 5 patients with repeated radiosurgery demonstrated secondary tumor growth control. Excluding atypical meningiomas, the growth control rate was 90.4%. The 1-, 5-, and 10-year actuarial tumor growth control rates are 98.9%, 94.2%, and 91.6%, respectively. Treatment failure was preceded by clinical symptoms in 14 of 15 patients. Most tumor growths appeared within 2.5 years. Only one third grew later (range, 6-20 yr). The complication rate was 6.0%: optic neuropathy (2), pituitary dysfunction (3), worsening of diplopia (1), and radiation edema (1). Mortality was 0. At last follow-up, 88.0% were able to live independent lives. CONCLUSION: GKS gives long-term growth control and has a low complication rate. Most tumor growths manifest within 3 years following treatment. However, some appear late, emphasizing the need for long-term follow-up.
PubMed ID
20305491 View in PubMed
Less detail