Azar M, Kazemi F, Jahanbakhshi A, Jalessi M, Amini E, Kazemi F, et al . Outcomes of Gamma Knife Radiosurgery in Patients With Parasagittal Meningioma. Iran J Neurosurg 2018; 4 (4) :205-212
URL:
http://irjns.org/article-1-133-en.html
1- MD. Professor of Neurosurgery, Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran
2- MD. Associate Professor of Neurosurgery, Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran
3- Assistant Professor of Neurosurgery, Skull Base Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
4- MD. Associate Professor of Otolaryngology- Head and Neck Surgery, Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran
5- MD. Research assistant, ENT and Head & Neck Research Center and Department, Iran University of Medical Sciences , Tehran, Iran
6- MD. Neurosurgeon, Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran
7- MD. Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran , dr.h.rahatlou@gmail.com
Abstract: (4780 Views)
Background & Aim: The treatment of Parasagittal Meningioma (PSM) is always a challenge, especially when the tumor has already invaded the critical structures like venous sinuses. This study aims at evaluating the outcomes of Gamma Knife Radiosurgery (GKRS) in patients with PSM.
Methods and Materials/Patients: In this descriptive retrospective study, we reviewed the medical records of 61 patients with PSM, who had undergone GKRS from 2003 to 2013. We reviewed their demographic characteristics, medical history, radiotherapy history, tumor volume, and the characteristics of radiosurgery. We also evaluated radiological tumor control following the treatment during the follow-up period.
Results: In this study, 32(52.5%) patients were men, and 29(47.5%) were women. Of 61 patients, 45 had a history of operation or and radiotherapy. Their Mean±SD tumor volume was 11.35±9.20 mL (range: 1-37.9mL). The Mean±SD follow-up time was 30.28±27.48 months, and during this time, five patients died. Radiologic tumor control was achieved in (91.8%) of the patients, in whom the tumor volume decreased in 30(49.2%) patients and remained unchanged in 26(42.6%) ones. The tumor volume increased in five (8.2%) patients. Overall, the progression-free survival of the patients was (98.6%) during 12 months, and their Mean±SD percentage was 67.04±13.4% during 60 months. The edema incidence rate was (18%). There was no significant difference in GKRS characteristics, tumor volume, the history of operation, and radiotherapy among the patients, whose tumors were controlled and the patients, who experienced an increase in the tumor volume.
Conclusion: Our study suggests that GKRS can be the first or second choice of treatment to control PSM. There was no association between the treatment outcome, tumor characteristics, and radiosurgery parameters. As radiosurgery management in PSMs has some limitations, a long-term follow-up is recommended to diagnose life-threatening complications, including brain edema.
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Highlights
● Parasagittal meningioma was controlled in majority of patients after gamma knife radiosurgery treatment
● Progression-free survival was 67.04% during 5 years.
● The results supported the effectiveness of gamma knife radiosurgery in management of parasagittal meningioma.
Plain Language Summary
Parasagittal Meningioma (PSM) is a type of tumor which fills the parasagittal angel of the brain. The management of tumor is a challenge because of its invasion to adjacent critical structures such as superior sagittal sinus. Recently, Gamma Knife Radiosurgery (GKRS) has been provided to reduce the various risks of open surgery which could be life threatening. We performed this study to evaluate the outcomes of GKRS in the management of PSMs. This study found that GKRS can control the tumor size. Thus, we suggest GKRS as the first or second option for the management of challengeable tumors such as PSM.