Less than total resections for skull base tumors (Joint Radiosurgery & Skull Base Parallel Session), October 15, 2024, 5:20 PM - 6:50 PM Background: Perioptic meningiomas are benign tumors arising in the proximity of the optic pathways. Despite showing non-aggressive features histologically in the majority of cases, they can grow to be a signi cant burden for patients’ quality of life, causing visual deterioration or other neurological de cits or symptoms. Surgical resection has historically been considered the mainstay for the treatment of these tumors but is often associated with non-negligible morbidity and mortality. Radiosurgery with Gamma Knife (GKRS) has progres- sively emerged as an effective alternative to surgery in some cases and nowadays is preferred when a patient may present contraindications to surgery. Methods: Our population comprised 185 patients harboring 190 meningiomas. Female patients were 139 (75.1%) and mean age of the population at the time of treatment was 56.7 years. One hundred-thirty-two tumors (69.5%) received fractionated GKRS (fGKRS) as primary treatment. At the time of treatment, mean target tumor volume was 7.2 cm3. For 89 lesions (46.8%), varying degrees of visual symptoms were present before the treatment. Mean clinical follow-up was 55.8 months and mean radiological follow-up was 46.7 months. Results: At last clinical follow-up, 6 patients had died (none of those died due to the meningioma). Mean overall survival (OS) was 123.6 months. Three-, 5- and 8-years OS was 98.8%, 96.5% and 94.1%, respectively. At last MRI, 95.8% of tumors appeared stable or reduced in size. At volumetric analysis (possible for 119 lesions which represented 62.6% of total tumors), a mean reduction of 18% of total volume was observed after treatment. Six lesions out of a total of 190 (3.2%) needed further treatments after radiosurgical treatment, so at last follow- up overall clinical tumor control (CTC) was 96.8%. Conclusions: Fractionated GKRS represents in our experience an effective treatment for perioptic meningiomas with limited morbidity
Safety, Efficacy And Feasibility Of Hypofractionated Gamma Knife Radiosurgery For Perioptic Meningiomas: Results From A Large Series / Pompeo, E; Bailo, M; Barzaghi, Lr; De Fazio, E; Snider, S; Roncelli, F; De Domenico, P; Mortini, F; Gagliardi, F.. - 4:supplement_3(2024), p. 103452. (Intervento presentato al convegno European Association of Neurosurgical Societies (EANS) 2024 Congress tenutosi a 13-17 Oct 2024 nel Sofia, Bulgaria) [10.1016/j.bas.2024.103452].
Safety, Efficacy And Feasibility Of Hypofractionated Gamma Knife Radiosurgery For Perioptic Meningiomas: Results From A Large Series
Pompeo EPrimo
;Bailo M;Roncelli F;De Domenico P;
2024-01-01
Abstract
Less than total resections for skull base tumors (Joint Radiosurgery & Skull Base Parallel Session), October 15, 2024, 5:20 PM - 6:50 PM Background: Perioptic meningiomas are benign tumors arising in the proximity of the optic pathways. Despite showing non-aggressive features histologically in the majority of cases, they can grow to be a signi cant burden for patients’ quality of life, causing visual deterioration or other neurological de cits or symptoms. Surgical resection has historically been considered the mainstay for the treatment of these tumors but is often associated with non-negligible morbidity and mortality. Radiosurgery with Gamma Knife (GKRS) has progres- sively emerged as an effective alternative to surgery in some cases and nowadays is preferred when a patient may present contraindications to surgery. Methods: Our population comprised 185 patients harboring 190 meningiomas. Female patients were 139 (75.1%) and mean age of the population at the time of treatment was 56.7 years. One hundred-thirty-two tumors (69.5%) received fractionated GKRS (fGKRS) as primary treatment. At the time of treatment, mean target tumor volume was 7.2 cm3. For 89 lesions (46.8%), varying degrees of visual symptoms were present before the treatment. Mean clinical follow-up was 55.8 months and mean radiological follow-up was 46.7 months. Results: At last clinical follow-up, 6 patients had died (none of those died due to the meningioma). Mean overall survival (OS) was 123.6 months. Three-, 5- and 8-years OS was 98.8%, 96.5% and 94.1%, respectively. At last MRI, 95.8% of tumors appeared stable or reduced in size. At volumetric analysis (possible for 119 lesions which represented 62.6% of total tumors), a mean reduction of 18% of total volume was observed after treatment. Six lesions out of a total of 190 (3.2%) needed further treatments after radiosurgical treatment, so at last follow- up overall clinical tumor control (CTC) was 96.8%. Conclusions: Fractionated GKRS represents in our experience an effective treatment for perioptic meningiomas with limited morbidityI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
