Long-term outcomes following upfront single-session gamma knife stereotactic radiosurgery for large volume meningiomas.

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuro-Oncology Pub Date : 2025-06-01 Epub Date: 2025-03-31 DOI:10.1007/s11060-025-05000-5

Suchet Taori, Zhishuo Wei, Constantinos G Hadjipanayis, Ajay Niranjan, L Dade Lunsford

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引用次数: 0

Abstract

Background: Stereotactic radiosurgery (SRS) for the management of small and medium-sized intracranial meningiomas is well defined. However, limited studies evaluating long-term outcomes following SRS for large-volume meningiomas (LVMs) exist. Here, we report a large single-institution experience in using upfront single-session SRS to manage LVMs.

Methods: This retrospective review included 112 patients (83 female, 74%) managed with single-session SRS for LVMs (> 10 cc) between 1987 and 2022. Exclusion criteria consisted of prior meningioma surgical resection or follow-up < 2 years. Tumors were classified as supratentorial (35%) or skull-base (65%). The median tumor volume was 13 cc (range: 10-24.7), and the median margin dose was 12 Gy (range: 10-15). Overall, 101 (90%) patients were neurologically symptomatic at SRS.

Results: The median follow-up was 106 months (range: 24-307). Sixteen (14%) LVMs demonstrated tumor progression at a median time of 43 months (range: 7-181) following SRS. Local tumor control (LTC) rates at 3-years, 5-years, and 10-years were 98% (95%CI: 91-99), 97% (95% CI: 94-100) and 88% (95% CI: 80-96), respectively. Tumor volume > 17 cc (HR: 3.26, 95% CI: 1.17-9.08, p = 0.023) was significantly associated with worsened LTC. Seven (6%) patients developed peritumoral edema adverse radiation effects (AREs) at a median time of 35 months (range: 4-182) following SRS. Meningiomas located in supratentorial regions (OR: 1.11, 95% CI: 1.01-1.22, p = 0.031), as compared to skull base tumors, had a significantly greater risk of peritumoral edema ARE development.

Conclusions: In this select patient cohort, upfront single-session SRS provides durable long-term LTC and minimizes ARE risk for patients with LVMs.

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大容量脑膜瘤单期伽玛刀立体定向放射治疗的远期疗效。

背景：立体定向放射外科（SRS）治疗中小型颅内脑膜瘤的方法是明确的。然而，评估SRS治疗大容量脑膜瘤（lvm）的长期结果的研究有限。在这里，我们报告了使用前置单会话SRS管理lvm的大型单机构经验。方法：本回顾性研究纳入了1987年至2022年间112例（83例女性，74%）采用单次SRS治疗lvm （bbb10 - 10cc）的患者。排除标准包括既往脑膜瘤手术切除或随访结果：中位随访时间为106个月（范围：24-307）。16例（14%）lvm在SRS后的中位时间为43个月（范围：7-181）出现肿瘤进展。3年、5年和10年的局部肿瘤控制率分别为98% （95%CI: 91-99）、97% （95%CI: 94-100）和88% （95%CI: 80-96）。肿瘤体积bbb17cc （HR: 3.26, 95% CI: 1.17-9.08, p = 0.023）与LTC恶化显著相关。7例（6%）患者在SRS后的中位35个月（范围：4-182）内出现肿瘤周围水肿不良辐射效应（AREs）。位于幕上区域的脑膜瘤（OR: 1.11, 95% CI: 1.01-1.22, p = 0.031），与颅底肿瘤相比，肿瘤周围水肿ARE发展的风险明显更高。结论：在这个选定的患者队列中，前期单次SRS提供了持久的长期LTC，并将lvm患者的ARE风险降至最低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.