Gamma Knife radiosurgery for neurofibromatosis type 2-associated meningiomas: a 22-year patient series

Brandon Birckhead, Terence T. Sio, Bruce E. Pollock, Michael J. Link, Nadia N Laack

Research output: Contribution to journalArticle

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Abstract

Neurofibromatosis type 2 (NF2) is a debilitating genetic condition with potential development of multiple meningiomas. We report our experience treating a series of NF2-associated intracranial meningiomas with Gamma Knife radiosurgery (GKRS). Between 1992 and 2013, 15 consecutive patients (age 20–54 years) with 62 intracranial meningiomas were treated with single-fraction GKRS. Fifty-five percent of tumors involved the convexity or parasagittal/falx. The median prescription dose was 16 Gy (range 13–20 Gy). The median tumor diameter was 2.1 cm (range 0.7–4.5 cm). The median radiographic and clinical follow-up periods were 103 and 111 months, respectively. The 5-year and 10-year local controls were both 96 %. The disease specific survival was 93 % at 5 years and 68 % at 10 years. Fifty-three percent of patients had multiple meningiomas and received multiple GKRS treatments (range 1–7) for new or enlarging intracranial meningiomas. 11 (73 %) patients were alive at last follow-up, with 60 (97 %) tumors controlled (smaller or unchanged in size). There were 2 in-field failures, one at 1 year and the other at 3.5 years. There were no marginal failures. Major Complications after GKRS included: 1 case of radiation necrosis, 1 case of post treatment edema, and 1 case of a presumed radiation induced cavernous malformation 5 years after GKRS. GK is an effective treatment for enlarging NF2–associated meningiomas. No cases of malignant transformation or secondary malignancies were seen during the follow-up period.

Original languageEnglish (US)
Pages (from-to)553-560
Number of pages8
JournalJournal of Neuro-Oncology
Volume130
Issue number3
DOIs
StatePublished - Dec 1 2016

Fingerprint

Neurofibromatosis 2
Radiosurgery
Meningioma
Neoplasms
Radiation
Prescriptions
Edema
Necrosis
Therapeutics
Survival

Keywords

  • Gamma Knife
  • Meningioma
  • Neurofibromatosis
  • Radiotherapy
  • Stereotactic radiosurgery

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Gamma Knife radiosurgery for neurofibromatosis type 2-associated meningiomas : a 22-year patient series. / Birckhead, Brandon; Sio, Terence T.; Pollock, Bruce E.; Link, Michael J.; Laack, Nadia N.

In: Journal of Neuro-Oncology, Vol. 130, No. 3, 01.12.2016, p. 553-560.

Research output: Contribution to journalArticle

Birckhead, Brandon ; Sio, Terence T. ; Pollock, Bruce E. ; Link, Michael J. ; Laack, Nadia N. / Gamma Knife radiosurgery for neurofibromatosis type 2-associated meningiomas : a 22-year patient series. In: Journal of Neuro-Oncology. 2016 ; Vol. 130, No. 3. pp. 553-560.
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AU - Laack, Nadia N

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N2 - Neurofibromatosis type 2 (NF2) is a debilitating genetic condition with potential development of multiple meningiomas. We report our experience treating a series of NF2-associated intracranial meningiomas with Gamma Knife radiosurgery (GKRS). Between 1992 and 2013, 15 consecutive patients (age 20–54 years) with 62 intracranial meningiomas were treated with single-fraction GKRS. Fifty-five percent of tumors involved the convexity or parasagittal/falx. The median prescription dose was 16 Gy (range 13–20 Gy). The median tumor diameter was 2.1 cm (range 0.7–4.5 cm). The median radiographic and clinical follow-up periods were 103 and 111 months, respectively. The 5-year and 10-year local controls were both 96 %. The disease specific survival was 93 % at 5 years and 68 % at 10 years. Fifty-three percent of patients had multiple meningiomas and received multiple GKRS treatments (range 1–7) for new or enlarging intracranial meningiomas. 11 (73 %) patients were alive at last follow-up, with 60 (97 %) tumors controlled (smaller or unchanged in size). There were 2 in-field failures, one at 1 year and the other at 3.5 years. There were no marginal failures. Major Complications after GKRS included: 1 case of radiation necrosis, 1 case of post treatment edema, and 1 case of a presumed radiation induced cavernous malformation 5 years after GKRS. GK is an effective treatment for enlarging NF2–associated meningiomas. No cases of malignant transformation or secondary malignancies were seen during the follow-up period.

AB - Neurofibromatosis type 2 (NF2) is a debilitating genetic condition with potential development of multiple meningiomas. We report our experience treating a series of NF2-associated intracranial meningiomas with Gamma Knife radiosurgery (GKRS). Between 1992 and 2013, 15 consecutive patients (age 20–54 years) with 62 intracranial meningiomas were treated with single-fraction GKRS. Fifty-five percent of tumors involved the convexity or parasagittal/falx. The median prescription dose was 16 Gy (range 13–20 Gy). The median tumor diameter was 2.1 cm (range 0.7–4.5 cm). The median radiographic and clinical follow-up periods were 103 and 111 months, respectively. The 5-year and 10-year local controls were both 96 %. The disease specific survival was 93 % at 5 years and 68 % at 10 years. Fifty-three percent of patients had multiple meningiomas and received multiple GKRS treatments (range 1–7) for new or enlarging intracranial meningiomas. 11 (73 %) patients were alive at last follow-up, with 60 (97 %) tumors controlled (smaller or unchanged in size). There were 2 in-field failures, one at 1 year and the other at 3.5 years. There were no marginal failures. Major Complications after GKRS included: 1 case of radiation necrosis, 1 case of post treatment edema, and 1 case of a presumed radiation induced cavernous malformation 5 years after GKRS. GK is an effective treatment for enlarging NF2–associated meningiomas. No cases of malignant transformation or secondary malignancies were seen during the follow-up period.

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