基于症状性颅底脑膜瘤位置的伽玛刀放射治疗后的神经学预后:单一机构经验

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2023-11-20 DOI:10.1016/j.inat.2023.101899

Farid Kazemi , Alireza Tabibkhooei , Mobin Naghshbandi , Vahid Ghorbani kalkhaje , Parisa Javadnia

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引用次数: 0

摘要

背景与目的颅底脑膜瘤因其高发病率而极具挑战性。伽玛刀放射外科治疗为SBM的治疗提供了一个有利的选择。本研究旨在评估GKRS作为SBM的辅助治疗或主要治疗后的神经系统预后。方法本回顾性横断面研究包括108例SBM患者，他们接受GKRS作为辅助或主要治疗。我们发现海绵窦脑膜瘤(CSM) 40例，岩斜坡脑膜瘤(PCM) 36例，桥小脑角脑膜瘤(CPM) 22例。其中女性占81.1% (n = 90)，中位年龄52.68岁。平均肿瘤体积为4.5 cm3，平均边际剂量为13 Gy。结果96.4%的患者在38.4个月的中位随访中获得肿瘤控制。108例患者中有17例(15.6%)报告其神经症状有所改善。与PCM和CSM患者相比，CPM患者表现出较低的神经症状改善率。11例患者(10.1%)出现GKRS后神经系统症状恶化，其中CSM患者的报告多于其他患者。在CSM、PCM和CPM患者中，脑神经缺损改善最大的分别是CNⅥ、Ⅴ、VIII。结论krs可作为SBM的主要或辅助治疗，可显著改善神经系统症状。

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Neurological outcomes after gamma knife radiosurgery for symptomatic skull base meningiomas based on their locations: Single institution experience

Background and objective

Gross total resection of skull base meningioma is so challenging due to its relevant high morbidity. Gamma knife radiosurgery is concerned by providing a favorable therapeutic option in the management of SBM. This study aims to evaluate the neurological outcome after GKRS as an adjuvant or primary treatment for SBM according to their locations.

Methods

This retrospective cross-sectional study consisted of 108 patients with SBM who underwent GKRS as an adjuvant or primary treatment. We found 40 patients with cavernous sinus meningioma (CSM), 36 patients with petroclival meningioma (PCM), and 22 patients with cerebellopontine angle meningioma (CPM). 81.1% of whom were female (n = 90) with a median age of 52.68 years. The mean tumor volume was 4.5 cm3 and the mean marginal dose was 13 Gy.

Results

Tumor control was achieved in 96.4 % of patients at a median follow-up of 38.4 months. Over all 17 of 108 patients (15.6%) report improvement in their neurological symptoms. Patients with CPM demonstrated lower rates of neurological symptoms improvement compared to patients with PCM and CSM. Deterioration of neurological symptoms after GKRS developed in 11 patients (10.1%) which was more reported by patients with CSM than the others. The most improvement in cranial nerve deficit was in CN Ⅵ, Ⅴ, VIII among patients with CSM, PCM, and CPM respectively.