Universität zu Köln

Ruess, Daniel, Fritsche, Fenja, Grau, Stefan, Treuer, Harald, Hoevels, Mauritius, Kocher, Martin, Baues, Christian and Ruge, Maximilian, I (2020). Stereotactic Radiosurgery of Cavernous Sinus Meningiomas. Journal of Neurol. Surg. Part B, 81 (2). S. 158 - 165. NEW YORK: THIEME MEDICAL PUBL INC. ISSN 2193-634X

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Abstract

Objective Microsurgical resection of cavernous sinus meningiomas (CSM) is associated with a high rate of incomplete resection, recurrence, and the risk for permanent, severe cranial nerve deficits. Stereotactic radiosurgery (SRS) has evolved as alternative treatment for primary and recurrent CSM. Here, we report about the long-term clinical and radiological follow-up (FU) of a unique cohort of patients with CSM treated with LINAC or Cyberknife based SRS. Methods In this single-center retrospective analysis, we include all patients with CSM who underwent single fraction SRS between 1993 and 2016. Clinical and radiological tumor control were evaluated by the Kaplan-Meier method. Additionally, patient data were analyzed in terms of symptom control and incidence of side effects rated by the common terminology criteria for adverse events (CTCAE; v4.03). Results 116 patients (female/male = 91/25; median age, 54 years; range, 33-82 years) were included. Mean tumor volume was 5.7 +/- 3.3 cm (3) (range, 0.6-16.2 cm (3) ), the median marginal dose was 12.6 Gy applied to isodose levels of 75%. Median clinical FU was 55 months (range, 3-226 months). Tumor control was 98% after 2 and 5 years and 90% after 10 years. Twelve patients (10.3%) had permanent or transient radiation related toxicity (CTCAE I-III). An improvement of symptoms was observed in 26.7% of the symptomatic patients ( n = 20 of 75). Conclusion SRS for CSM provides excellent long-term tumor and symptom control without considerable permanent side effects. Thus, SRS should be considered when counseling patients suffering from CSM.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Fritsche, Fenja UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoevels, Mauritius UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Baues, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian, I UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-339066
DOI:	10.1055/s-0039-1683430
Journal or Publication Title:	Journal of Neurol. Surg. Part B
Volume:	81
Number:	2
Page Range:	S. 158 - 165
Date:	2020
Publisher:	THIEME MEDICAL PUBL INC
Place of Publication:	NEW YORK
ISSN:	2193-634X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GAMMA-KNIFE RADIOSURGERY; LINEAR-ACCELERATOR RADIOSURGERY; LONG-TERM OUTCOMES; CRANIAL NERVES; TUMOR-CONTROL; FOLLOW-UP; MANAGEMENT; SURGERY; EXPERIENCE Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33906