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(a) The prescription dose was 12 Gy, delivered to an isodose line of 50.0%. (b) At the six-month follow-up, the tumor shrank significantly. (c) However, a new tumor developed and was treated with a prescription dose of 14 Gy, delivered to the 52% isodose line using GKRS. (d) The second tumor shrank significantly at the 27-month follow-up after the initial GKRS. (e) Simultaneously, a new tumor was treated with the third GKRS at a prescription dose of 13 Gy, delivered to the 50% isodose line. (f) At the 35-month follow-up after the initial GKRS, the third tumor had increased in size, while the first tumor remained under control. EBRT, external beam radiotherapy; GKRS, gamma knife radiosurgery.
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Credit: Shibin Sun, Enmeng Bao
Background and objectives
The role of radiosurgery in the treatment of grade 2 meningioma remains unclear. This study aimed to evaluate the long-term outcomes of gamma knife radiosurgery (GKRS) in patients with grade 2 meningiomas and to identify factors influencing tumor control and survival.
Methods
In this retrospective study, seventy patients underwent GKRS for grade 2 meningioma between 2007 and 2016. Tumor recurrence was categorized as local, marginal, or distant. Survival curves were estimated using the Kaplan-Meier method, while the log-rank test and Cox proportional hazards model were employed to analyze potential risk factors.
Results
The median follow-up period was 48 months (range: 8 to 132 months). The one-year, three-year, and five-year local control rates were 92%, 73%, and 65%, respectively. The one-, three-, and three-year progression-free survival rates were 87%, 51%, and 44%, respectively. Multiple lesions and multiple prior recurrences were identified as negative predictors of marginal control and progression-free survival. Similarly, multiple lesions and marginal doses ≤13 Gy were associated with poor local control. Serious complications related to gamma knife use occurred in 4% of patients.
Conclusions
Our results support the use of GKRS as a reasonable treatment option in the management of grade 2 meningiomas. A higher margin dose should be considered to achieve better local control. Outfield progression (marginal and/or distant recurrence) was common, particularly in patients with multiple prior recurrences and/or multiple lesions. More aggressive treatment strategies should be explored for patients with these risk factors.
Full text:
The study was recently published in the Neurosurgical Subspecialties.
Neurosurgical Subspecialties (NSSS) is the official scientific journal of the Department of Neurosurgery at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. NSSS aims to provide a forum for clinicians and scientists in the field, dedicated to publishing high-quality and peer-reviewed original research, reviews, opinions, commentaries, case reports, and letters across all neurosurgical subspecialties. These include but are not limited to traumatic brain injury, spinal and spinal cord neurosurgery, cerebrovascular disease, stereotactic radiosurgery, neuro-oncology, neurocritical care, neurosurgical nursing, neuroendoscopy, pediatric neurosurgery, peripheral neuropathy, and functional neurosurgery.
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Journal
Neurosurgical Subspecialties
DOI
10.14218/NSSS.2024.00002
Article Title
The Role of Gamma Knife Radiosurgery in the Management of Grade 2 Meningioma
Article Publication Date
17-Dec-2024
Media Contact
Shelly Zhang
Xia & He Publishing Inc.
Journal
Neurosurgical Subspecialties
DOI
10.14218/NSSS.2024.00002
Journal
Neurosurgical Subspecialties
DOI
10.14218/NSSS.2024.00002
Article Title
The Role of Gamma Knife Radiosurgery in the Management of Grade 2 Meningioma
Article Publication Date
17-Dec-2024
Keywords
/Health and medicine/Diseases and disorders/Cancer/Meningioma
/Health and medicine/Medical specialties/Neurology/Neurosurgery
/Health and medicine/Clinical medicine/Medical treatments/Cancer treatments/Radiation therapy/Gamma knife treatment
bu içeriği en az 2000 kelime olacak şekilde ve alt başlıklar ve madde içermiyecek şekilde ünlü bir science magazine için İngilizce olarak yeniden yaz. Teknik açıklamalar içersin ve viral olacak şekilde İngilizce yaz. Haber dışında başka bir şey içermesin. Haber içerisinde en az 12 paragraf ve her bir paragrafta da en az 50 kelime olsun. Cevapta sadece haber olsun. Ayrıca haberi yazdıktan sonra içerikten yararlanarak aşağıdaki başlıkların bilgisi var ise haberin altında doldur. Eğer yoksa bilgisi ilgili kısmı yazma.:
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Keywords
Tags: case studies in gamma knife radiosurgeryeffectiveness of gamma knife in tumor controlexternal beam radiotherapy vs GKRSfollow-up results of gamma knife treatmentgamma knife radiosurgery for meningiomaisodose line in GKRS treatmentlong-term outcomes of meningioma treatmentmanagement of grade 2 meningiomanew tumor development post-radiosurgeryprecision in radiosurgery dosingprescription dose in radiosurgerytumor shrinkage after GKRS
