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Journal of Neuro-Oncology
Published in: Journal of Neuro-Oncology 2/2018

01-09-2018 | Clinical Study

Cranial nerve outcomes after primary stereotactic radiosurgery for symptomatic skull base meningiomas

Authors: Andrew Faramand, Hideyuki Kano, Ajay Niranjan, Stephen A. Johnson, Mohab Hassib, Kyung-Jae Park, Yoshio Arai, John C. Flickinger, L. Dade Lunsford

Published in: Journal of Neuro-Oncology | Issue 2/2018

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Abstract

Objective

To evaluate cranial nerve (CN) outcomes after primary stereotactic radiosurgery (SRS) for petroclival, cavernous sinus, and cerebellopontine angle meningiomas.

Methods

From our prospectively maintained database of 2022 meningioma patients who underwent Leksell stereotactic radiosurgery (SRS) during a 30-year interval, we found 98 patients with petroclival, 242 with cavernous sinus, and 55 patients with cerebellopontine angle meningiomas. Primary radiosurgery was performed in 245 patients. Patients included in this report had at least one CN deficit at the time of initial presentation and a minimum of 12 month follow up. Median age at the time of SRS was 58 years. Median follow up was 58 months (range 12–300 months), Median tumor volume treated with SRS was 5.9 cm3 (range 0.5–37.5 cm3), and median margin dose was 13 Gy (range 9–20Gy).

Results

Tumor control was achieved in 229 patients (93.5%) at a median follow up of 58 months. Progression free survival rate (PFS) after SRS was 98.7% at 1 year, 96.4% at 3 years, 93.7% at 5 years, and 86.4% at 10 years Overall, 114 of the 245 patients (46.5%) reported improvement of CN function. Patients with CP angle meningiomas demonstrated lower rates of CN improvement compared to petroclival and cavernous sinus meningioma patients. Deterioration of CN function after SRS developed in 24 patients (10%). The rate of deterioration was 2.8% at 1 year, 5.2% at 3 years, and 8% at 10 years.

Conclusion

Primary SRS provides effective tumor control and favorable rate of improvement of preexisting CN deficit.
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Metadata
Title
Cranial nerve outcomes after primary stereotactic radiosurgery for symptomatic skull base meningiomas
Authors
Andrew Faramand
Hideyuki Kano
Ajay Niranjan
Stephen A. Johnson
Mohab Hassib
Kyung-Jae Park
Yoshio Arai
John C. Flickinger
L. Dade Lunsford
Publication date
01-09-2018
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-018-2866-9

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