Preservation of Cranial Nerve Function Following Gamma Knife Radiosurgery for Benign Skull Base Meningiomas: Experience in 121 Patients with Follow-up of 5 to 9.8 Years

2002 ◽  
pp. 71-76 ◽  
Author(s):  
Sandro Eustacchio ◽  
M. Trummer ◽  
I. Fuchs ◽  
O. Schröttner ◽  
B. Sutter ◽  
...  
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Cranial Nerve ◽  
Gamma Knife Radiosurgery ◽  
Nerve Function ◽  
Cranial Nerve Function ◽  
Skull Base Meningiomas

scholarly journals Fractionated Gamma Knife radiosurgery for skull base meningiomas: a single-institution experience

2019 ◽  
Vol 46 (6) ◽  
pp. E8 ◽  
Author(s):  
Krishna C. Joshi ◽  
Alankrita Raghavan ◽  
Baha’eddin Muhsen ◽  
Jason Hsieh ◽  
Hamid Borghei-Razavi ◽  
...  
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
Cranial Neuropathy ◽  
High Dose ◽  
Perilesional Edema ◽  
The Mean ◽  
Skull Base Meningiomas

OBJECTIVEGamma Knife radiosurgery (GKRS) has been successfully used for the treatment of intracranial meningiomas given its steep dose gradients and high-dose conformality. However, treatment of skull base meningiomas (SBMs) may pose significant risk to adjacent radiation-sensitive structures such as the cranial nerves. Fractionated GKRS (fGKRS) may decrease this risk, but until recently it has not been practical with traditional pin-based systems. This study reports the authors’ experience in treating SBMs with fGKRS, using a relocatable, noninvasive immobilization system.METHODSThe authors performed a retrospective review of all patients who underwent fGKRS for SBMs between 2013 and 2018 delivered using the Extend relocatable frame system or the Icon system. Patient demographics, pre- and post-GKRS tumor characteristics, perilesional edema, prior treatment details, and clinical symptoms were evaluated. Volumetric analysis of pre-GKRS, post-GKRS, and subsequent follow-up visits was performed.RESULTSTwenty-five patients met inclusion criteria. Nineteen patients were treated with the Icon system, and 6 patients were treated with the Extend system. The mean pre-fGKRS tumor volume was 7.62 cm3 (range 4.57–13.07 cm3). The median margin dose was 25 Gy delivered in 4 (8%) or 5 (92%) fractions. The median follow-up time was 12.4 months (range 4.7–17.4 months). Two patients (9%) experienced new-onset cranial neuropathy at the first follow-up. The mean postoperative tumor volume reduction was 15.9% with 6 patients (27%) experiencing improvement of cranial neuropathy at the first follow-up. Median first follow-up scans were obtained at 3.4 months (range 2.8–4.3 months). Three patients (12%) developed asymptomatic, mild perilesional edema by the first follow-up, which remained stable subsequently.CONCLUSIONSfGKRS with relocatable, noninvasive immobilization systems is well tolerated in patients with SBMs and demonstrated satisfactory tumor control as well as limited radiation toxicity. Future prospective studies with long-term follow-up and comparison to single-session GKRS or fractionated stereotactic radiotherapy are necessary to validate these findings and determine the efficacy of this approach in the management of SBMs.

Gamma-Knife Radiosurgery for Skull Base Meningiomas: Experience of Tumor Control, Clinical Course and Morbidity in a Follow-Up of More Than 8 Years

Skull Base ◽  
2009 ◽  
Vol 19 (01) ◽  
Author(s):  
Brigitte Gatterbauer ◽  
Iris Zachenhofer ◽  
Klaus Kitz ◽  
Karl Rössler ◽  
Stefan Wolfsberger ◽  
...  
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Clinical Course ◽  
Gamma Knife Radiosurgery ◽  
Tumor Control ◽  
Skull Base Meningiomas

Risk of injury to cranial nerves after gamma knife radiosurgery for skull base meningiomas: experience in 88 patients

1999 ◽  
Vol 90 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Akio Morita ◽  
Robert J. Coffey ◽  
Robert L. Foote ◽  
David Schiff ◽  
Deborah Gorman
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Cranial Nerves ◽  
Gamma Knife Radiosurgery ◽  
Median Dose ◽  
Trigeminal Neuropathy ◽  
Content Type ◽  
Skull Base Meningiomas ◽  
Fine Print

Object. In this study the authors sought to determine the neurological risks and potential clinical benefits of gamma knife radiosurgery for skull base meningiomas.Methods. A consecutive series of 88 patients harboring skull base meningiomas were treated between 1990 and 1996 by using the Leksell gamma knife in a prospective clinical study that included a strict dose—volume protocol. Forty-nine patients had previously undergone surgery, and six had received external-beam radiotherapy. The median treatment volume was 10 cm3, and the median dose to the tumor margin was 16 Gy. The radiosurgical dosage to the optic nerve, the cavernous sinus, and Meckel's cave was calculated and correlated with clinical outcome. The median patient follow-up time was 35 months (range 12–83 months).Two tumors (2.3%) progressed after radiosurgery; the progression-free 5-year survival rate was 95%. At last follow-up review, 60 (68%) tumors were smaller and 26 (29.5%) remained unchanged. Clinical improvement (in vision, trigeminal pain, or other cranial nerve symptoms) occurred in 15 patients. Functioning optic nerves received a median dose of 10 Gy (range 1–16 Gy), and no treatment-induced visual loss occurred. Among nine patients with new trigeminal neuropathy, six received doses of more than 19 Gy to Meckel's cave.Conclusions. Gamma knife radiosurgery appeared to be an effective method to control the growth of most skull base meningiomas in this intermediate-term study. The risk of trigeminal neuropathy seemed to be associated with doses of more than 19 Gy, and the optic apparatus appeared to tolerate doses greater than 10 Gy. Considering the risks to cranial nerves associated with open surgery for comparable tumors, the authors believe that gamma knife radiosurgery is a useful method for the management of properly selected recurrent, residual, or newly diagnosed skull base meningiomas.

scholarly journals Staged Gamma Knife Radiosurgery for Large Skull Base Meningiomas

Cureus ◽  
2019 ◽  
Author(s):  
Yoshiyasu Iwai ◽  
Kazuhiro Yamanaka ◽  
Wataru Shimohonji ◽  
Kenichi Ishibashi
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Skull Base Meningiomas

scholarly journals Outcomes and Complications of Gamma Knife Radiosurgery for Skull Base Meningiomas

2014 ◽  
Vol 75 (06) ◽  
pp. 397-401 ◽  
Author(s):  
Shyamal Bir ◽  
Sudheer Ambekar ◽  
Tabitha Ward ◽  
Anil Nanda
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Skull Base Meningiomas

Gamma Knife Radiosurgery of Skull Base Meningiomas

2000 ◽  
Vol 142 (6) ◽  
pp. 647-653 ◽  
Author(s):  
M. Aichholzer ◽  
A. Bertalanffy ◽  
W. Dietrich ◽  
K. Roessler ◽  
W. Pfisterer ◽  
...  
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Skull Base Meningiomas

Gamma Knife Radiosurgery for Skull Base Meningiomas: Long-Term Radiologic and Clinical Outcome

2008 ◽  
Vol 72 (5) ◽  
pp. 1324-1332 ◽  
Author(s):  
Jung Ho Han ◽  
Dong Gyu Kim ◽  
Hyun-Tai Chung ◽  
Chul-Kee Park ◽  
Sun Ha Paek ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Skull Base ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Skull Base Meningiomas

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Wolfgang Kreil ◽  
Sandro Eustacchio ◽  
Verena Weigl ◽  
Josef Luggin ◽  
Georg Papaefthymiou ◽  
...  
Keyword(s):  
Skull Base ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Skull Base Meningiomas ◽  
Long Term Experience
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