| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Wang, Wei-Hsin Lee, Cheng-Chia Yang, Huai-Che Liu, Kang-Du Wu, Hsiu-Mei Shiau, Cheng-Ying Guo, Wan-You Pan, David Hung-Chi Chung, Wen-Yuh Chen, Ming-Teh |
| Description |
Country affiliation: Taiwan Author Affiliation: Wang WH ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan); Lee CC ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan); Yang HC ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan); Liu KD ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan); Wu HM ( School of Medicine, National Yang-Ming University, Taipei, Taiwan); Shiau CY ( School of Medicine, National Yang-Ming University, Taipei, Taiwan); Guo WY ( School of Medicine, National Yang-Ming University, Taipei, Taiwan); Pan DH ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan); Chung WY ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan); Chen MT ( Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan) |
| Abstract |
BACKGROUND: Atypical and anaplastic meningiomas have much higher recurrence rates after surgical resection compared with benign meningiomas, but the role of adjuvant radiosurgery remains unclear. This study was undertaken to evaluate the outcomes of gamma knife radiosurgery for patients with atypical and anaplastic meningiomas. METHODS: In this retrospective analysis of a prospectively maintained database, 46 patients with histologically proven atypical or anaplastic meningiomas by current World Health Organization (WHO) criteria underwent postoperative Gamma Knife radiosurgery between 1993 and 2013. The median follow-up period was 32.6 months. The median tumor volume and margin dose were 11.7 mL (range, 2-53 mL) and 13.1 Gy (range, 12.0-16.5 Gy), respectively. RESULTS: Local control at 3 and 5 years was 50.6% and 32.1%, respectively. Gender (P = 0.013) and marginal dose less than or equal to 13 Gy (P = 0.049) were associated with the local control. The 3- and 5-year overall survival for patients with WHO grade II was 97.1% and 88.3%, respectively, compared with 66.7% and 66.7% for patients with WHO grade III meningiomas. Radiation therapy before Gamma Knife radiosurgery (GKRS; P = 0.018) and tumor grade (P = 0.019) were the factors associated with a worse overall survival rate. Fourteen patients (30.4%) developed adverse radiation effects after GKRS treatment, and all were Radiation Therapy Oncology Group grade I. CONCLUSIONS: Postoperative GKRS treatment for patients with atypical and anaplastic meningioma is challenging. More aggressive treatment, including of safely maximizing the extent of surgical resection and using a higher margin dose (>13Gy), should be applied to achieve better local control. |
| File Format |
HTM / HTML |
| ISSN |
18788750 |
| Volume Number |
87 |
| e-ISSN |
18788769 |
| Journal |
World Neurosurgery |
| Language |
English |
| Publisher |
Elsevier |
| Publisher Date |
2016-03-01 |
| Publisher Place |
United States |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Discipline Neurosurgery Meningioma Surgery Radiosurgery Methods Adolescent Adult Aged Aged, 80 And Over Disease-free Survival Female Follow-up Studies Humans Kaplan-meier Estimate Male Pathology Middle Aged Radiation Dosage Adverse Effects Retrospective Studies Sex Characteristics Survival Analysis Treatment Outcome Young Adult Journal Article |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Neurology (clinical) Surgery |
