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KMID : 0942820080070020113
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Journal of Korean Brain Tumor Society
2008 Volume.7 No. 2 p.113 ~ p.119
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Clinical Analysis of Novalis Radiosurgery for Skull Base Meningioma
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Ahn Sang-Hyun
Son Moon-Jun
Yoon Sang-Won
Han Seong-Rok
Choi Chan-Young
Lee Dong-Joon
Lee Chae-Heuck
Whang Choong-Jin
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Abstract
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Objective: Stereotactic radiosurgery is becoming an important surgical treatment option in neurosurgical field. Optimal treatment protocol and proper clinical applications could minimize early and late toxicity associated with the radiosurgical treatment. This study is to analyze the clinical results of Novalis radiosurgery for skull base meningioma.
Methods: Between Nov. 2001 and Jan. 2006, 43 patients underwent radiosurgery using Novalis shaped beam surgery unit. Male to female ratio was 13：30(1：2.3) with the mean age of 54.2 year-old(range 28-73 year-old). Total of 36 lesions were included to analyze dosimetric data and volume changes during the follow-up period. Median of follow up period was 26.8 months(range 2-60 months). The dosage prescriptions were determined on the basis of tumor volume, location, and proximity to optic nerve and brainstem.
Results: 13 lesions were treated in a single session but 23 lesions were irradiated in fractionation. The mean initial tumor volume of a single session and fractionated radiosurgery was 4.4±4.0 cm3 and 22.4±18.4 cm3, respectively, while follow-up tumor volume following radiosurgery was significantly decreased to 3.1±4.5 cm3 and 13.4±12.3 cm3, respectively( p<0.05). Overall local tumor control rate was 97.2%(35 lesions)；however, there was no radiation related toxicity during the follow up periods.
Conclusion: Novalis radiosurgery for skull base meningiomas offers an effective local tumor control in using either single session or fractionated irradiation. With advent of modern radiosurgical treatment and developed optimal clinical protocol, we could successfully treat this surgically difficult tumor to control including larger tumors and tumors adjacent to sellar & parasellar regions.
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KEYWORD
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Novalis radiosurgery, Skull base meningioma, Intensity modulated radiosurgery(IMRS), Micromultileaf collimators(mMLCs), Fractionated radiosurgery
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