Introduction: Meningiomas are the most frequent benign intracranial tumors.Although microsurgery is gold standart treatment for meningiomas,sterotactic radiosurgery is a safe and effective option for tumors smaller than 3 cm.In this study,we aimed to analyze the results of sterotacticradiosurgery in 270 patients with residual or recurrent gradeI meningiomas
Methods: Retrospective review of 661 patients,who were treated in Gazi University Gamma Knife Center between 2004-2013 was performed.270 patients (40.8%)operated and histopathological result was grade 1 meningiomas .Grade 2 (26 patients) and 3 ( 6 patients) meningiomas were excluded. Total 270 patients (96 women, 174 men) were reviewed. The median follow-up was 78.1 months.The location, volume,dose,number of shots,prescription rates,complications,response rates were analysed.
Results: The median age was 64.1years(55-83).The median irradiated tumor volume was 12045.8mm3(6300-47700). The median tumor prescription ratio was 99.91%.The median dose was 15.5 Gy. The tumor control rate was:%96.9 (no growth in %75.1, volume reduction in %21.8 ). Increase in volume was seen in 8 patients (%2.9) and re-operation was performed in one of them (0.37%) . Stereotactic radiosurgery was perfomed again for 7 patients(3.7%).The location of the tumors were as follows:20.7%sellar – parasellar, %40.7 cerebellopontin cistern , % 9.6 sphenoid wing, other % 23.3 and % 5.5 was multiple. New neurological deficits or worsening of the symptoms occured in 3 (%1.1) patients. Non-specific symptoms like headache,dizziness etc were detected in1.1%of the patients.Improvement in neurologic deficit (better visual acuity)was determined in 2 patients(0.7%)
Conclusions: Stereotactic radiosurgery should not be considered as the primary treatment for lesions with mass effect,requiring decompression.Safer microsurgical resection of meningiomas can be achieved by only debulking and leaving the critical parts of the tumor like cavernous sinus or surrounding cerebral arteries for radiosurgery. Only decompression of critical structures like optic nerve and brainstem, leaving the remnant for stereotactic radiosurgery is also a rational treatment option
Patient Care: Sterotactic Radiosurgery is non-invasive treatment modality for residual menengioma patients.This treatment modality is good option to avoid repeated operation risk for recurrence menengioma patients.
Learning Objectives: Evaulate effectiveness of Radiosurgery for Grade 1 menengiomas