Complications after gamma knife radiosurgery for benign meningiomas

J. H. Chang, J. W. Chang, J. Y. Choi, Y. G. Park, S. S. Chung

Research output: Contribution to journalArticle

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Abstract

Objectives: To analyse the results of gamma knife radiosurgery (GKS) for the trreatment of intracranial meningiomas and to assess possible factors related to the outcome and complications of such treatment. Methods: The authors retrospectively reviewed the clinical and radiological data of 179 patients (194 lesions) treated with GKS for meningiomas between May 1992 and October 2000. The mean follow up duration was 37.3 months (range 6.4 to 86.3 months). The study determined the correlation between radiosurgical outcome including imaging changes after GKS and multiple factors such as tumour location and size, patient characteristics, venous sinus status, pre-GKS degree of oedema, other treatment modalities, and radiosurgical parameters. Results: The radiological control rate was 97.1%. Magnetic resonance imaging (MRI) showed complications after GKS in 35 lesions (25.0%) among the 140 lesions followed up with MRI. Complications were divided into peritumorous imaging changes (33 lesions; 23.6%) and transient cranial nerve dysfunction (two lesions; 1.4%). Radiation induced imaging changes were seen mostly in convexity, parasagittal, and falx meningiomas that were deeply embedded in the cortex. About 60% of these were asymptomatic and the overall rate of symptomatic imaging changes was 9.3%. Neurological deficit related to imaging changes developed in only three patients, and all the symptoms were transient. Conclusion: GKS for intracranial meningiomas seems to be a safe and effective treatment. However, meningiomas of the convexity, parasagittal region, or falx cerebri have a higher incidence of peritumorous imaging changes after GKS than those of the skull base. Therefore, the use of GKS needs to be considered very cautiously in cerebral hemispheric meningiomas, taking into consideration patient age and general condition, tumour size and location, pattern of cortical embedding, relation between the tumour and venous sinuses, presenting symptoms, and patient preference.

Original languageEnglish
Pages (from-to)226-230
Number of pages5
JournalJournal of Neurology Neurosurgery and Psychiatry
Volume74
Issue number2
DOIs
Publication statusPublished - 2003 Feb 1

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Radiosurgery
Meningioma
Magnetic Resonance Imaging
Neoplasms
Patient Preference
Cranial Nerves
Skull Base
Edema
Spinal Cord
Therapeutics
Radiation
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Chang, J. H. ; Chang, J. W. ; Choi, J. Y. ; Park, Y. G. ; Chung, S. S. / Complications after gamma knife radiosurgery for benign meningiomas. In: Journal of Neurology Neurosurgery and Psychiatry. 2003 ; Vol. 74, No. 2. pp. 226-230.
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abstract = "Objectives: To analyse the results of gamma knife radiosurgery (GKS) for the trreatment of intracranial meningiomas and to assess possible factors related to the outcome and complications of such treatment. Methods: The authors retrospectively reviewed the clinical and radiological data of 179 patients (194 lesions) treated with GKS for meningiomas between May 1992 and October 2000. The mean follow up duration was 37.3 months (range 6.4 to 86.3 months). The study determined the correlation between radiosurgical outcome including imaging changes after GKS and multiple factors such as tumour location and size, patient characteristics, venous sinus status, pre-GKS degree of oedema, other treatment modalities, and radiosurgical parameters. Results: The radiological control rate was 97.1{\%}. Magnetic resonance imaging (MRI) showed complications after GKS in 35 lesions (25.0{\%}) among the 140 lesions followed up with MRI. Complications were divided into peritumorous imaging changes (33 lesions; 23.6{\%}) and transient cranial nerve dysfunction (two lesions; 1.4{\%}). Radiation induced imaging changes were seen mostly in convexity, parasagittal, and falx meningiomas that were deeply embedded in the cortex. About 60{\%} of these were asymptomatic and the overall rate of symptomatic imaging changes was 9.3{\%}. Neurological deficit related to imaging changes developed in only three patients, and all the symptoms were transient. Conclusion: GKS for intracranial meningiomas seems to be a safe and effective treatment. However, meningiomas of the convexity, parasagittal region, or falx cerebri have a higher incidence of peritumorous imaging changes after GKS than those of the skull base. Therefore, the use of GKS needs to be considered very cautiously in cerebral hemispheric meningiomas, taking into consideration patient age and general condition, tumour size and location, pattern of cortical embedding, relation between the tumour and venous sinuses, presenting symptoms, and patient preference.",
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Complications after gamma knife radiosurgery for benign meningiomas. / Chang, J. H.; Chang, J. W.; Choi, J. Y.; Park, Y. G.; Chung, S. S.

In: Journal of Neurology Neurosurgery and Psychiatry, Vol. 74, No. 2, 01.02.2003, p. 226-230.

Research output: Contribution to journalArticle

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N2 - Objectives: To analyse the results of gamma knife radiosurgery (GKS) for the trreatment of intracranial meningiomas and to assess possible factors related to the outcome and complications of such treatment. Methods: The authors retrospectively reviewed the clinical and radiological data of 179 patients (194 lesions) treated with GKS for meningiomas between May 1992 and October 2000. The mean follow up duration was 37.3 months (range 6.4 to 86.3 months). The study determined the correlation between radiosurgical outcome including imaging changes after GKS and multiple factors such as tumour location and size, patient characteristics, venous sinus status, pre-GKS degree of oedema, other treatment modalities, and radiosurgical parameters. Results: The radiological control rate was 97.1%. Magnetic resonance imaging (MRI) showed complications after GKS in 35 lesions (25.0%) among the 140 lesions followed up with MRI. Complications were divided into peritumorous imaging changes (33 lesions; 23.6%) and transient cranial nerve dysfunction (two lesions; 1.4%). Radiation induced imaging changes were seen mostly in convexity, parasagittal, and falx meningiomas that were deeply embedded in the cortex. About 60% of these were asymptomatic and the overall rate of symptomatic imaging changes was 9.3%. Neurological deficit related to imaging changes developed in only three patients, and all the symptoms were transient. Conclusion: GKS for intracranial meningiomas seems to be a safe and effective treatment. However, meningiomas of the convexity, parasagittal region, or falx cerebri have a higher incidence of peritumorous imaging changes after GKS than those of the skull base. Therefore, the use of GKS needs to be considered very cautiously in cerebral hemispheric meningiomas, taking into consideration patient age and general condition, tumour size and location, pattern of cortical embedding, relation between the tumour and venous sinuses, presenting symptoms, and patient preference.

AB - Objectives: To analyse the results of gamma knife radiosurgery (GKS) for the trreatment of intracranial meningiomas and to assess possible factors related to the outcome and complications of such treatment. Methods: The authors retrospectively reviewed the clinical and radiological data of 179 patients (194 lesions) treated with GKS for meningiomas between May 1992 and October 2000. The mean follow up duration was 37.3 months (range 6.4 to 86.3 months). The study determined the correlation between radiosurgical outcome including imaging changes after GKS and multiple factors such as tumour location and size, patient characteristics, venous sinus status, pre-GKS degree of oedema, other treatment modalities, and radiosurgical parameters. Results: The radiological control rate was 97.1%. Magnetic resonance imaging (MRI) showed complications after GKS in 35 lesions (25.0%) among the 140 lesions followed up with MRI. Complications were divided into peritumorous imaging changes (33 lesions; 23.6%) and transient cranial nerve dysfunction (two lesions; 1.4%). Radiation induced imaging changes were seen mostly in convexity, parasagittal, and falx meningiomas that were deeply embedded in the cortex. About 60% of these were asymptomatic and the overall rate of symptomatic imaging changes was 9.3%. Neurological deficit related to imaging changes developed in only three patients, and all the symptoms were transient. Conclusion: GKS for intracranial meningiomas seems to be a safe and effective treatment. However, meningiomas of the convexity, parasagittal region, or falx cerebri have a higher incidence of peritumorous imaging changes after GKS than those of the skull base. Therefore, the use of GKS needs to be considered very cautiously in cerebral hemispheric meningiomas, taking into consideration patient age and general condition, tumour size and location, pattern of cortical embedding, relation between the tumour and venous sinuses, presenting symptoms, and patient preference.

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