|標題：Gamma knife radiosurgery for the treatment of cavernous sinus meningiomas: post-treatment long-term clinical outcomes, complications, and volume changes|
|作品名稱||Gamma knife radiosurgery for the treatment of cavernous sinus meningiomas: post-treatment long-term clinical outcomes, complications, and volume changes|
|著者||Yi‑Chieh Hung; Cheng‑Chia Lee; Wan‑Yuo Guo; Cheng‑Ying Shiau; Yue‑Cune Chang; David Hung‑Chi Pan; Jason P. Sheehan; Wen‑Yuh Chung|
|著錄名稱、卷期、頁數||Journal of Neuro-oncology 141(2), p.261-270|
|摘要||Purpose To evaluate the outcomes of patients who underwent Gamma Knife radiosurgery (GKRS) for the treatment of
cavernous sinus (CS) meningiomas.
Methods We retrospectively reviewed the clinical and radiological outcomes of 95 patients with CS meningiomas at Taipei
Veterans General Hospital between 1993 and 2011. The study cohort comprised 27 men and 68 women with a median age
of 50 years (range 29–79 years). The median pre-GKRS tumor volume was 6.6 ml (range 0.9–35.7 ml). The median margin
dose was 12 Gy (range 11–21 Gy). The clinical factors related to favorable outcomes were assessed.
Results The median follow-up period was 59 (range 12–209) months. At the final follow-up, the tumor volume regressed in
70 patients (74%) and progressed in eight (8%). Kaplan–Meier analysis revealed that the progression-free survival rates at 5
and 10 years were 92.7% and 81.2%, respectively. Three patients (3.2%) experienced exacerbated cranial nerve dysfunction
following radiosurgery. Confined tumors were found to be an independent prognostic factor for tumor control and shorter
times to regression in the multivariable analyses. No risk factor for tumor progression was identified in either the univariate
or multivariate analyses.
Conclusions GKRS provides good long-term tumor control and is associated with low cranial nerve–related morbidity development
rates in patients with small- to medium-sized CS meningiomas. Confined tumor could be an independent prognostic
factor for tumor control and shorter times to regression in multivariate analysis. Life-long follow-up is mandatory in such
settings, even for outpatients with shrunken or stabilized tumors.
|關鍵字||Cavernous sinus;Meningioma;Prognostic factor;Radiosurgery|