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KMID : 0892920180270030245
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Experimental Neurobiology
2018 Volume.27 No. 3 p.245 ~ p.255
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Fractionated Gamma Knife Radiosurgery as Initial Treatment for Large Skull Base Meningioma
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Park Hye-Ran
Lee Jae-Meen
Park Kwang-Woo
Kim Jung-Hoon
Jeong Sang-Soon
Kim Jin-Wook
Chung Hyun-Tai
Kim Dong-Gyu
Paek Sun-Ha
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Abstract
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We present our experience on the hypofractionated Gamma Knife radiosurgery (FGKS) for large skull base meningioma as an initial treatment. We retrospectively reviewed 23 patients with large skull base meningioma ≥10 cm3 who underwent FGKS as the initial treatment option. The mean volume of tumors prior to radiosurgery was 21.2±15.63 cm3 (range, 10.09~71.42). The median total margin dose and marginal dose per fraction were 18 Gy (range, 15~20) and 6 Gy (range, 5~6), respectively. Patients underwent three or four fractionations in consecutive days with the same Leksell® frame. The mean follow-up duration was 38 months (range, 17~78). There was no mortality. At the last follow-up, the tumor volume was stationary in 15 patients (65.2%) and had decreased in 8 patients (34.8%). Six patients who had cranial neuropathy at the time of FGKS showed improvement at the last clinical follow-up. Following FGKS, 4 patients (17%) had new cranial neuropathy. The trigeminal neuropathy was the most common and all were transient. The mean Karnofsky Performance Status score at pre-FGKS and the last clinical follow-up was 97.0±10.4 points (median, 100) and 98.6±6.9 (median, 100) points, respectively. FGKS has showed satisfactory tumor control with functional preservation for large skull base meningiomas. Further prospective studies of large cohorts with long term follow-up are required to clarify the efficacy in the tumor control and functional outcome as well as radiation toxicity.
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KEYWORD
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Gamma Knife Radiosurgery, Dose Hypofractionation, Meningioma, Skull Base, Stereotactic Radiosurgery
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