• Neurosurgery · Mar 2021

    Multicenter Study

    Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study.

    • Adomas Bunevicius, Rithika Kormath Anand, Mohanad Suleiman, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdelkarim, El-ShehabyAmr M NAMNGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.Neurosurgery Department, Ain Shams University, Cairo, Egypt., Reem M Emad, Tomas Chytka, Roman Liscak, Kimball Sheehan, Darrah Sheehan, Marco Perez Caceres, David Mathieu, Cheng-Chia Lee, Huai-Che Yang, Piero Picozzi, Andrea Franzini, Luca Attuati, Herwin Speckter, Jeremy Olivo, Samir Patel, Christopher P Cifarelli, Daniel T Cifarelli, Joshua D Hack, Ben A Strickland, Gabriel Zada, Eric L Chang, Kareem R Fakhoury, Chad G Rusthoven, Ronald E Warnick, and Jason Sheehan.
    • Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
    • Neurosurgery. 2021 Mar 15; 88 (4): 828-837.

    BackgroundStereotactic radiosurgery (SRS) is increasingly used for management of perioptic meningiomas.ObjectiveTo study the safety and effectiveness of SRS for perioptic meningiomas.MethodsFrom 12 institutions participating in the International Radiosurgery Research Foundation (IRRF), we retrospectively assessed treatment parameters and outcomes following SRS for meningiomas located within 3 mm of the optic apparatus.ResultsA total of 438 patients (median age 51 yr) underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) perioptic meningiomas. Median treatment volume was 8.01 cm3. Median prescription dose was 12 Gy, and median dose to the optic apparatus was 8.50 Gy. A total of 405 patients (93%) underwent single-fraction SRS and 33 patients (7%) underwent hypofractionated SRS. During median imaging follow-up of 55.6 mo (range: 3.15-239 mo), 33 (8%) patients experienced tumor progression. Actuarial 5-yr and 10-yr progression-free survival was 96% and 89%, respectively. Prescription dose of ≥12 Gy (HR: 0.310; 95% CI [0.141-0.679], P = .003) and single-fraction SRS (HR: 0.078; 95% CI [0.016-0.395], P = .002) were associated with improved tumor control. A total of 31 (10%) patients experienced visual decline, with actuarial 5-yr and 10-yr post-SRS visual decline rates of 9% and 21%, respectively. Maximum dose to the optic apparatus ≥10 Gy (HR = 2.370; 95% CI [1.086-5.172], P = .03) and tumor progression (HR = 4.340; 95% CI [2.070-9.097], P < .001) were independent predictors of post-SRS visual decline.ConclusionSRS provides durable tumor control and quite acceptable rates of vision preservation in perioptic meningiomas. Margin dose of ≥12 Gy is associated with improved tumor control, while a dose to the optic apparatus of ≥10 Gy and tumor progression are associated with post-SRS visual decline.© Congress of Neurological Surgeons 2021.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…