Meningioma radiosurgery: Tumor control, outcomes, and complications among 190 consecutive patients

Scott L. Stafford, Bruce E. Pollock, Robert L. Foote, Michael J. Link, Deborah A. Gorman, Paula J. Schomberg, Jacqueline A. Leavitt

Research output: Contribution to journalArticle

282 Citations (Scopus)

Abstract

OBJECTIVE: To determine local control (LC) and complication rates for patients with intracranial meningiomas who underwent radiosurgery. METHODS: One hundred ninety consecutive patients with 206 meningiomas underwent radiosurgery between 1990 and 1998. One hundred forty-seven tumors (77%) involved the cranial base. The median age at the time of radiosurgery was 58 years (range, 20-90 yr). There were 126 female patients (66%). One hundred twelve patients (59%) had undergone one or more previous operations (median, 1; range, 1-5). Twenty-two patients (12%) had either atypical (n = 13) or malignant (n = 9) tumors. The median prescription isodose volume was 8.2 cm3 (range, 0.5-50.5 cm3), and the median tumor margin dose was 16 Gy (range, 12-36 Gy). The median imaging and clinical follow-up periods were 40 and 47 months, respectively. RESULTS: Overall survival rates for the entire cohort at 5 and 7 years were 82 and 82%, respectively; cause-specific survival rates at 5 and 7 years were 94 and 92%, respectively. The cause-specific survival rates at 5 years for patients with benign, atypical, and malignant tumors were 100, 76, and 0%, respectively (P < 0.0001). The 5-year LC rate was 89%, with 114 tumors (56%) decreasing in size. LC rates were correlated with tumor histological features (P < 0.0001); patients with benign tumors exhibited a 5-year LC rate of 93%, compared with 68 and 0% for patients with atypical or malignant meningiomas, respectively. No correlation was observed between radiation dose and LC rate. Twenty-four patients (13%) experienced treatment-related complications, including cranial nerve deficits (8%), symptomatic parenchymal changes (3%), internal carotid artery stenosis (1%), and symptomatic cyst formation (1%). Only six patients (3%) exhibited decreases in functional status that were directly related to radiosurgery. Tumor volume, tumor margin dose, or previous radiotherapy was not associated with the development of radiation-related complications. CONCLUSION: Radiosurgery is an effective management strategy for many patients with meningiomas. Patients with atypical or malignant tumors exhibit high recurrence rates despite the use of radiosurgery, and these patients continue to exhibit worse cause-specific survival rates despite aggressive treatment, including surgery, externalbeam radiotherapy, and radiosurgery. Further study is needed to determine the tumor control and complication rates 10 years or more after meningioma radiosurgery.

Original languageEnglish (US)
Pages (from-to)1029-1038
Number of pages10
JournalNeurosurgery
Volume49
Issue number5
StatePublished - 2001

Fingerprint

Radiosurgery
Meningioma
Neoplasms
Survival Rate
Radiotherapy
Radiation
Cranial Nerves
Carotid Stenosis
Skull Base
Tumor Burden
Prescriptions
Cysts

Keywords

  • Brain tumor
  • Complications
  • Meningioma
  • Stereotactic radiosurgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Stafford, S. L., Pollock, B. E., Foote, R. L., Link, M. J., Gorman, D. A., Schomberg, P. J., & Leavitt, J. A. (2001). Meningioma radiosurgery: Tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery, 49(5), 1029-1038.

Meningioma radiosurgery : Tumor control, outcomes, and complications among 190 consecutive patients. / Stafford, Scott L.; Pollock, Bruce E.; Foote, Robert L.; Link, Michael J.; Gorman, Deborah A.; Schomberg, Paula J.; Leavitt, Jacqueline A.

In: Neurosurgery, Vol. 49, No. 5, 2001, p. 1029-1038.

Research output: Contribution to journalArticle

Stafford, SL, Pollock, BE, Foote, RL, Link, MJ, Gorman, DA, Schomberg, PJ & Leavitt, JA 2001, 'Meningioma radiosurgery: Tumor control, outcomes, and complications among 190 consecutive patients', Neurosurgery, vol. 49, no. 5, pp. 1029-1038.
Stafford SL, Pollock BE, Foote RL, Link MJ, Gorman DA, Schomberg PJ et al. Meningioma radiosurgery: Tumor control, outcomes, and complications among 190 consecutive patients. Neurosurgery. 2001;49(5):1029-1038.
Stafford, Scott L. ; Pollock, Bruce E. ; Foote, Robert L. ; Link, Michael J. ; Gorman, Deborah A. ; Schomberg, Paula J. ; Leavitt, Jacqueline A. / Meningioma radiosurgery : Tumor control, outcomes, and complications among 190 consecutive patients. In: Neurosurgery. 2001 ; Vol. 49, No. 5. pp. 1029-1038.
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T2 - Tumor control, outcomes, and complications among 190 consecutive patients

AU - Stafford, Scott L.

AU - Pollock, Bruce E.

AU - Foote, Robert L.

AU - Link, Michael J.

AU - Gorman, Deborah A.

AU - Schomberg, Paula J.

AU - Leavitt, Jacqueline A.

PY - 2001

Y1 - 2001

N2 - OBJECTIVE: To determine local control (LC) and complication rates for patients with intracranial meningiomas who underwent radiosurgery. METHODS: One hundred ninety consecutive patients with 206 meningiomas underwent radiosurgery between 1990 and 1998. One hundred forty-seven tumors (77%) involved the cranial base. The median age at the time of radiosurgery was 58 years (range, 20-90 yr). There were 126 female patients (66%). One hundred twelve patients (59%) had undergone one or more previous operations (median, 1; range, 1-5). Twenty-two patients (12%) had either atypical (n = 13) or malignant (n = 9) tumors. The median prescription isodose volume was 8.2 cm3 (range, 0.5-50.5 cm3), and the median tumor margin dose was 16 Gy (range, 12-36 Gy). The median imaging and clinical follow-up periods were 40 and 47 months, respectively. RESULTS: Overall survival rates for the entire cohort at 5 and 7 years were 82 and 82%, respectively; cause-specific survival rates at 5 and 7 years were 94 and 92%, respectively. The cause-specific survival rates at 5 years for patients with benign, atypical, and malignant tumors were 100, 76, and 0%, respectively (P < 0.0001). The 5-year LC rate was 89%, with 114 tumors (56%) decreasing in size. LC rates were correlated with tumor histological features (P < 0.0001); patients with benign tumors exhibited a 5-year LC rate of 93%, compared with 68 and 0% for patients with atypical or malignant meningiomas, respectively. No correlation was observed between radiation dose and LC rate. Twenty-four patients (13%) experienced treatment-related complications, including cranial nerve deficits (8%), symptomatic parenchymal changes (3%), internal carotid artery stenosis (1%), and symptomatic cyst formation (1%). Only six patients (3%) exhibited decreases in functional status that were directly related to radiosurgery. Tumor volume, tumor margin dose, or previous radiotherapy was not associated with the development of radiation-related complications. CONCLUSION: Radiosurgery is an effective management strategy for many patients with meningiomas. Patients with atypical or malignant tumors exhibit high recurrence rates despite the use of radiosurgery, and these patients continue to exhibit worse cause-specific survival rates despite aggressive treatment, including surgery, externalbeam radiotherapy, and radiosurgery. Further study is needed to determine the tumor control and complication rates 10 years or more after meningioma radiosurgery.

AB - OBJECTIVE: To determine local control (LC) and complication rates for patients with intracranial meningiomas who underwent radiosurgery. METHODS: One hundred ninety consecutive patients with 206 meningiomas underwent radiosurgery between 1990 and 1998. One hundred forty-seven tumors (77%) involved the cranial base. The median age at the time of radiosurgery was 58 years (range, 20-90 yr). There were 126 female patients (66%). One hundred twelve patients (59%) had undergone one or more previous operations (median, 1; range, 1-5). Twenty-two patients (12%) had either atypical (n = 13) or malignant (n = 9) tumors. The median prescription isodose volume was 8.2 cm3 (range, 0.5-50.5 cm3), and the median tumor margin dose was 16 Gy (range, 12-36 Gy). The median imaging and clinical follow-up periods were 40 and 47 months, respectively. RESULTS: Overall survival rates for the entire cohort at 5 and 7 years were 82 and 82%, respectively; cause-specific survival rates at 5 and 7 years were 94 and 92%, respectively. The cause-specific survival rates at 5 years for patients with benign, atypical, and malignant tumors were 100, 76, and 0%, respectively (P < 0.0001). The 5-year LC rate was 89%, with 114 tumors (56%) decreasing in size. LC rates were correlated with tumor histological features (P < 0.0001); patients with benign tumors exhibited a 5-year LC rate of 93%, compared with 68 and 0% for patients with atypical or malignant meningiomas, respectively. No correlation was observed between radiation dose and LC rate. Twenty-four patients (13%) experienced treatment-related complications, including cranial nerve deficits (8%), symptomatic parenchymal changes (3%), internal carotid artery stenosis (1%), and symptomatic cyst formation (1%). Only six patients (3%) exhibited decreases in functional status that were directly related to radiosurgery. Tumor volume, tumor margin dose, or previous radiotherapy was not associated with the development of radiation-related complications. CONCLUSION: Radiosurgery is an effective management strategy for many patients with meningiomas. Patients with atypical or malignant tumors exhibit high recurrence rates despite the use of radiosurgery, and these patients continue to exhibit worse cause-specific survival rates despite aggressive treatment, including surgery, externalbeam radiotherapy, and radiosurgery. Further study is needed to determine the tumor control and complication rates 10 years or more after meningioma radiosurgery.

KW - Brain tumor

KW - Complications

KW - Meningioma

KW - Stereotactic radiosurgery

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