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KMID : 0942820090080010041
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Journal of Korean Brain Tumor Society
2009 Volume.8 No. 1 p.41 ~ p.46
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Treatment Results of Gamma Knife Radiosurgery using Low Radiation dose for Skull Base Meningiomas
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Park Hyun-Woong
Jung Shin
Moon Kyung-Sub
Lim Dong-Ho
Kim In-Young
Park Seung-Jin
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Abstract
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Objective: Recently, gamma knife radiosurgery has been applied to skull base meningiomas as a primary or postoperative adjuvant treatment, due to the high morbidity and mortality of conventional surgery. We analyzed the results of gamma knife radiosurgery for selective cases of skull base meningiomas using low radiation doses for the tumor control.
Patients & Methods: Between June 2004 and January 2007, We reviewed 40 of 48 patients treated with gamma knife radiosurgery for skull base meningiomas. The mean patient age at the time of gamma knife radiosurgery was 60.1 years (range, 28-86 yr). There were 28 female and 12 male patients. Ten patients(25.0%) had radiosurgery as an adjuvant treatment after microsurgery, and 30 patients(75.0%) underwent radiosurgery as the primary treatment. The mean radiological follow-up period was 39.3 months(range, 24.5-56.8 months). The tumor control, neuroradiological and neurological outcomes, and adverse effects were analyzed during the follow-up period.
Results: The mean tumor volume was 11.4 cc(range 0.5-48.3 cc). The main symptoms before radiosurgery were cranial nerve palsies. The dose delivered at the tumor margin ranged from 8 to 14 Gy(mean dose 11.9 Gy). Tumor control was achieved in 37 of the 40 patients(92.5%). All 40 patients were survived. During the follow-up period, the neurological symptoms and signs improved in 25 of the 40 patients who underwent gamma knife radiosurgery, remained stable in 15 including 5 incidental patients, and no delayed worsening or new cranial nerve deficits were observed after radiosurgery.
Conclusion: Gamma knife radiosurgery, using a relatively low radiation dose(less than 15 Gy) can provide good tumor control rate without any morbidity in skull base meningiomas.
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KEYWORD
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Gamma knife radiosurgery, Low dose radiation, Skull base meningioma, Surgical result
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