Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study
Purpose Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas. Methods From twelve institutions participating in th...
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| Veröffentlicht in: | Acta neurochirurgica 2021-10, Vol.163 (10), p.2861-2869 |
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| creator | Bunevicius, Adomas Pikis, Stylianos Anand, Rithika Kormath Nabeel, Ahmed M. Reda, Wael A. Tawadros, Sameh R. Abdelkarim, Khaled El-Shehaby, Amr M. N. Emad, Reem M. Chytka, Tomas Liscak, Roman Caceres, Marco Perez Mathieu, David Lee, Cheng-chia Yang, Huai-che Picozzi, Piero Franzini, Andrea Attuati, Luca Speckter, Herwin Olivo, Jeremy Patel, Samir Cifarelli, Christopher P. Cifarelli, Daniel T. Hack, Joshua D. Strickland, Ben A. Zada, Gabriel Chang, Eric L. Fakhoury, Kareem R. Rusthoven, Chad G. Warnick, Ronald E. Sheehan, Jason |
| description | Purpose
Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas.
Methods
From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas.
Results
Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm
3
, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700,
p
= 0.007) and pre-SRS radiotherapy (HR = 0.004,
p
|
| doi_str_mv | 10.1007/s00701-021-04972-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2564138997</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2564138997</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-5aa2f1e810585d904ca8efcdd682545773a17d63c8a2e5f216bb416f95c916d23</originalsourceid><addsrcrecordid>eNp9kMtKAzEUhoMoWKsv4GrAjZvRXCaXcSfFqlB0oa5DmmRKysyk5rLo25s6guDCRU5OyPcfDh8AlwjeIAj5bSwFohricpqW45ocgRlsG1yXAo9LD8s3w0ycgrMYt-WFeUNm4OUt2WB9Ujo5XQVlnI85bGzYV50Ple7d6J2pBju6ceP8oOJdpaoh98nVbozJpZycH1VfxZTN_hycdKqP9uLnnoOP5cP74qlevT4-L-5XtSYUp5oqhTtkBYJUUNPCRithO20ME5g2lHOiEDeMaKGwpR1GbL1uEOtaqlvEDCZzcD3N3QX_mW1McnBR275Xo_U5SkxZg4hoW17Qqz_o1udQNj5QHEPOqBCFwhOlg48x2E7ughtU2EsE5UGxnBTLolh-K5akhMgUigUei7Tf0f-kvgDgt37U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2572076588</pqid></control><display><type>article</type><title>Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study</title><source>Springer Online Journals Complete</source><creator>Bunevicius, Adomas ; Pikis, Stylianos ; Anand, Rithika Kormath ; Nabeel, Ahmed M. ; Reda, Wael A. ; Tawadros, Sameh R. ; Abdelkarim, Khaled ; El-Shehaby, Amr M. N. ; Emad, Reem M. ; Chytka, Tomas ; Liscak, Roman ; Caceres, Marco Perez ; Mathieu, David ; Lee, Cheng-chia ; Yang, Huai-che ; Picozzi, Piero ; Franzini, Andrea ; Attuati, Luca ; Speckter, Herwin ; Olivo, Jeremy ; Patel, Samir ; Cifarelli, Christopher P. ; Cifarelli, Daniel T. ; Hack, Joshua D. ; Strickland, Ben A. ; Zada, Gabriel ; Chang, Eric L. ; Fakhoury, Kareem R. ; Rusthoven, Chad G. ; Warnick, Ronald E. ; Sheehan, Jason</creator><creatorcontrib>Bunevicius, Adomas ; Pikis, Stylianos ; Anand, Rithika Kormath ; Nabeel, Ahmed M. ; Reda, Wael A. ; Tawadros, Sameh R. ; Abdelkarim, Khaled ; El-Shehaby, Amr M. N. ; Emad, Reem M. ; Chytka, Tomas ; Liscak, Roman ; Caceres, Marco Perez ; Mathieu, David ; Lee, Cheng-chia ; Yang, Huai-che ; Picozzi, Piero ; Franzini, Andrea ; Attuati, Luca ; Speckter, Herwin ; Olivo, Jeremy ; Patel, Samir ; Cifarelli, Christopher P. ; Cifarelli, Daniel T. ; Hack, Joshua D. ; Strickland, Ben A. ; Zada, Gabriel ; Chang, Eric L. ; Fakhoury, Kareem R. ; Rusthoven, Chad G. ; Warnick, Ronald E. ; Sheehan, Jason</creatorcontrib><description>Purpose
Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas.
Methods
From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas.
Results
Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm
3
, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700,
p
= 0.007) and pre-SRS radiotherapy (HR = 0.004,
p
< 0.001) were independent predictors of better tumor control. During median visual follow-up of 48 months, visual function declined in 8% of patients. Pre-SRS visual deficit (HR = 2.938,
p
= 0.048) and maximal radiation dose to the optic apparatus of ≥ 10 Gy (HR = 11.297,
p
= 0.02) independently predicted greater risk of post-SRS visual decline. Four patients experienced new post-SRS cranial nerve V neuropathy.
Conclusions
SRS allows durable control of clinoid meningiomas and visual preservation in the majority of patients. Greater radiosurgical prescription dose is associated with better tumor control. Radiation dose to the optic apparatus of ≥ 10 Gy and visual impairment before the SRS increase risk of visual deterioration.</description><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-021-04972-3</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Brain cancer ; Cranial nerves ; Interventional Radiology ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Morbidity ; Neurology ; Neuroradiology ; Neurosurgery ; Optic neuropathy ; Original Article - Tumor - Meningioma ; Patients ; Radiation ; Radiation therapy ; Radiosurgery ; Surgical Orthopedics ; Tumor – Meningioma ; Tumors ; Visual perception</subject><ispartof>Acta neurochirurgica, 2021-10, Vol.163 (10), p.2861-2869</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-5aa2f1e810585d904ca8efcdd682545773a17d63c8a2e5f216bb416f95c916d23</citedby><cites>FETCH-LOGICAL-c352t-5aa2f1e810585d904ca8efcdd682545773a17d63c8a2e5f216bb416f95c916d23</cites><orcidid>0000-0003-0446-6898</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00701-021-04972-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00701-021-04972-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids></links><search><creatorcontrib>Bunevicius, Adomas</creatorcontrib><creatorcontrib>Pikis, Stylianos</creatorcontrib><creatorcontrib>Anand, Rithika Kormath</creatorcontrib><creatorcontrib>Nabeel, Ahmed M.</creatorcontrib><creatorcontrib>Reda, Wael A.</creatorcontrib><creatorcontrib>Tawadros, Sameh R.</creatorcontrib><creatorcontrib>Abdelkarim, Khaled</creatorcontrib><creatorcontrib>El-Shehaby, Amr M. N.</creatorcontrib><creatorcontrib>Emad, Reem M.</creatorcontrib><creatorcontrib>Chytka, Tomas</creatorcontrib><creatorcontrib>Liscak, Roman</creatorcontrib><creatorcontrib>Caceres, Marco Perez</creatorcontrib><creatorcontrib>Mathieu, David</creatorcontrib><creatorcontrib>Lee, Cheng-chia</creatorcontrib><creatorcontrib>Yang, Huai-che</creatorcontrib><creatorcontrib>Picozzi, Piero</creatorcontrib><creatorcontrib>Franzini, Andrea</creatorcontrib><creatorcontrib>Attuati, Luca</creatorcontrib><creatorcontrib>Speckter, Herwin</creatorcontrib><creatorcontrib>Olivo, Jeremy</creatorcontrib><creatorcontrib>Patel, Samir</creatorcontrib><creatorcontrib>Cifarelli, Christopher P.</creatorcontrib><creatorcontrib>Cifarelli, Daniel T.</creatorcontrib><creatorcontrib>Hack, Joshua D.</creatorcontrib><creatorcontrib>Strickland, Ben A.</creatorcontrib><creatorcontrib>Zada, Gabriel</creatorcontrib><creatorcontrib>Chang, Eric L.</creatorcontrib><creatorcontrib>Fakhoury, Kareem R.</creatorcontrib><creatorcontrib>Rusthoven, Chad G.</creatorcontrib><creatorcontrib>Warnick, Ronald E.</creatorcontrib><creatorcontrib>Sheehan, Jason</creatorcontrib><title>Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><description>Purpose
Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas.
Methods
From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas.
Results
Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm
3
, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700,
p
= 0.007) and pre-SRS radiotherapy (HR = 0.004,
p
< 0.001) were independent predictors of better tumor control. During median visual follow-up of 48 months, visual function declined in 8% of patients. Pre-SRS visual deficit (HR = 2.938,
p
= 0.048) and maximal radiation dose to the optic apparatus of ≥ 10 Gy (HR = 11.297,
p
= 0.02) independently predicted greater risk of post-SRS visual decline. Four patients experienced new post-SRS cranial nerve V neuropathy.
Conclusions
SRS allows durable control of clinoid meningiomas and visual preservation in the majority of patients. Greater radiosurgical prescription dose is associated with better tumor control. Radiation dose to the optic apparatus of ≥ 10 Gy and visual impairment before the SRS increase risk of visual deterioration.</description><subject>Brain cancer</subject><subject>Cranial nerves</subject><subject>Interventional Radiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally Invasive Surgery</subject><subject>Morbidity</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Optic neuropathy</subject><subject>Original Article - Tumor - Meningioma</subject><subject>Patients</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>Radiosurgery</subject><subject>Surgical Orthopedics</subject><subject>Tumor – Meningioma</subject><subject>Tumors</subject><subject>Visual perception</subject><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kMtKAzEUhoMoWKsv4GrAjZvRXCaXcSfFqlB0oa5DmmRKysyk5rLo25s6guDCRU5OyPcfDh8AlwjeIAj5bSwFohricpqW45ocgRlsG1yXAo9LD8s3w0ycgrMYt-WFeUNm4OUt2WB9Ujo5XQVlnI85bGzYV50Ple7d6J2pBju6ceP8oOJdpaoh98nVbozJpZycH1VfxZTN_hycdKqP9uLnnoOP5cP74qlevT4-L-5XtSYUp5oqhTtkBYJUUNPCRithO20ME5g2lHOiEDeMaKGwpR1GbL1uEOtaqlvEDCZzcD3N3QX_mW1McnBR275Xo_U5SkxZg4hoW17Qqz_o1udQNj5QHEPOqBCFwhOlg48x2E7ughtU2EsE5UGxnBTLolh-K5akhMgUigUei7Tf0f-kvgDgt37U</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Bunevicius, Adomas</creator><creator>Pikis, Stylianos</creator><creator>Anand, Rithika Kormath</creator><creator>Nabeel, Ahmed M.</creator><creator>Reda, Wael A.</creator><creator>Tawadros, Sameh R.</creator><creator>Abdelkarim, Khaled</creator><creator>El-Shehaby, Amr M. N.</creator><creator>Emad, Reem M.</creator><creator>Chytka, Tomas</creator><creator>Liscak, Roman</creator><creator>Caceres, Marco Perez</creator><creator>Mathieu, David</creator><creator>Lee, Cheng-chia</creator><creator>Yang, Huai-che</creator><creator>Picozzi, Piero</creator><creator>Franzini, Andrea</creator><creator>Attuati, Luca</creator><creator>Speckter, Herwin</creator><creator>Olivo, Jeremy</creator><creator>Patel, Samir</creator><creator>Cifarelli, Christopher P.</creator><creator>Cifarelli, Daniel T.</creator><creator>Hack, Joshua D.</creator><creator>Strickland, Ben A.</creator><creator>Zada, Gabriel</creator><creator>Chang, Eric L.</creator><creator>Fakhoury, Kareem R.</creator><creator>Rusthoven, Chad G.</creator><creator>Warnick, Ronald E.</creator><creator>Sheehan, Jason</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0446-6898</orcidid></search><sort><creationdate>20211001</creationdate><title>Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study</title><author>Bunevicius, Adomas ; Pikis, Stylianos ; Anand, Rithika Kormath ; Nabeel, Ahmed M. ; Reda, Wael A. ; Tawadros, Sameh R. ; Abdelkarim, Khaled ; El-Shehaby, Amr M. N. ; Emad, Reem M. ; Chytka, Tomas ; Liscak, Roman ; Caceres, Marco Perez ; Mathieu, David ; Lee, Cheng-chia ; Yang, Huai-che ; Picozzi, Piero ; Franzini, Andrea ; Attuati, Luca ; Speckter, Herwin ; Olivo, Jeremy ; Patel, Samir ; Cifarelli, Christopher P. ; Cifarelli, Daniel T. ; Hack, Joshua D. ; Strickland, Ben A. ; Zada, Gabriel ; Chang, Eric L. ; Fakhoury, Kareem R. ; Rusthoven, Chad G. ; Warnick, Ronald E. ; Sheehan, Jason</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-5aa2f1e810585d904ca8efcdd682545773a17d63c8a2e5f216bb416f95c916d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Brain cancer</topic><topic>Cranial nerves</topic><topic>Interventional Radiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally Invasive Surgery</topic><topic>Morbidity</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Optic neuropathy</topic><topic>Original Article - Tumor - Meningioma</topic><topic>Patients</topic><topic>Radiation</topic><topic>Radiation therapy</topic><topic>Radiosurgery</topic><topic>Surgical Orthopedics</topic><topic>Tumor – Meningioma</topic><topic>Tumors</topic><topic>Visual perception</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bunevicius, Adomas</creatorcontrib><creatorcontrib>Pikis, Stylianos</creatorcontrib><creatorcontrib>Anand, Rithika Kormath</creatorcontrib><creatorcontrib>Nabeel, Ahmed M.</creatorcontrib><creatorcontrib>Reda, Wael A.</creatorcontrib><creatorcontrib>Tawadros, Sameh R.</creatorcontrib><creatorcontrib>Abdelkarim, Khaled</creatorcontrib><creatorcontrib>El-Shehaby, Amr M. N.</creatorcontrib><creatorcontrib>Emad, Reem M.</creatorcontrib><creatorcontrib>Chytka, Tomas</creatorcontrib><creatorcontrib>Liscak, Roman</creatorcontrib><creatorcontrib>Caceres, Marco Perez</creatorcontrib><creatorcontrib>Mathieu, David</creatorcontrib><creatorcontrib>Lee, Cheng-chia</creatorcontrib><creatorcontrib>Yang, Huai-che</creatorcontrib><creatorcontrib>Picozzi, Piero</creatorcontrib><creatorcontrib>Franzini, Andrea</creatorcontrib><creatorcontrib>Attuati, Luca</creatorcontrib><creatorcontrib>Speckter, Herwin</creatorcontrib><creatorcontrib>Olivo, Jeremy</creatorcontrib><creatorcontrib>Patel, Samir</creatorcontrib><creatorcontrib>Cifarelli, Christopher P.</creatorcontrib><creatorcontrib>Cifarelli, Daniel T.</creatorcontrib><creatorcontrib>Hack, Joshua D.</creatorcontrib><creatorcontrib>Strickland, Ben A.</creatorcontrib><creatorcontrib>Zada, Gabriel</creatorcontrib><creatorcontrib>Chang, Eric L.</creatorcontrib><creatorcontrib>Fakhoury, Kareem R.</creatorcontrib><creatorcontrib>Rusthoven, Chad G.</creatorcontrib><creatorcontrib>Warnick, Ronald E.</creatorcontrib><creatorcontrib>Sheehan, Jason</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bunevicius, Adomas</au><au>Pikis, Stylianos</au><au>Anand, Rithika Kormath</au><au>Nabeel, Ahmed M.</au><au>Reda, Wael A.</au><au>Tawadros, Sameh R.</au><au>Abdelkarim, Khaled</au><au>El-Shehaby, Amr M. N.</au><au>Emad, Reem M.</au><au>Chytka, Tomas</au><au>Liscak, Roman</au><au>Caceres, Marco Perez</au><au>Mathieu, David</au><au>Lee, Cheng-chia</au><au>Yang, Huai-che</au><au>Picozzi, Piero</au><au>Franzini, Andrea</au><au>Attuati, Luca</au><au>Speckter, Herwin</au><au>Olivo, Jeremy</au><au>Patel, Samir</au><au>Cifarelli, Christopher P.</au><au>Cifarelli, Daniel T.</au><au>Hack, Joshua D.</au><au>Strickland, Ben A.</au><au>Zada, Gabriel</au><au>Chang, Eric L.</au><au>Fakhoury, Kareem R.</au><au>Rusthoven, Chad G.</au><au>Warnick, Ronald E.</au><au>Sheehan, Jason</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><date>2021-10-01</date><risdate>2021</risdate><volume>163</volume><issue>10</issue><spage>2861</spage><epage>2869</epage><pages>2861-2869</pages><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Purpose
Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas.
Methods
From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas.
Results
Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm
3
, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700,
p
= 0.007) and pre-SRS radiotherapy (HR = 0.004,
p
< 0.001) were independent predictors of better tumor control. During median visual follow-up of 48 months, visual function declined in 8% of patients. Pre-SRS visual deficit (HR = 2.938,
p
= 0.048) and maximal radiation dose to the optic apparatus of ≥ 10 Gy (HR = 11.297,
p
= 0.02) independently predicted greater risk of post-SRS visual decline. Four patients experienced new post-SRS cranial nerve V neuropathy.
Conclusions
SRS allows durable control of clinoid meningiomas and visual preservation in the majority of patients. Greater radiosurgical prescription dose is associated with better tumor control. Radiation dose to the optic apparatus of ≥ 10 Gy and visual impairment before the SRS increase risk of visual deterioration.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><doi>10.1007/s00701-021-04972-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0446-6898</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Acta neurochirurgica, 2021-10, Vol.163 (10), p.2861-2869 |
| issn | 0001-6268 0942-0940 |
| language | eng |
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| source | Springer Online Journals Complete |
| subjects | Brain cancer Cranial nerves Interventional Radiology Medicine Medicine & Public Health Minimally Invasive Surgery Morbidity Neurology Neuroradiology Neurosurgery Optic neuropathy Original Article - Tumor - Meningioma Patients Radiation Radiation therapy Radiosurgery Surgical Orthopedics Tumor – Meningioma Tumors Visual perception |
| title | Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study |
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