Linear Accelerator Radiosurgery for Meningiomas

ABSTRACT

Radiosurgery has been used to treat a variety of intracranial disorders, including arteriovenous malformations, metastatic brain tumors, vestibular schwannomas, and meningiomas. Radiosurgery is an outpatient treatment, with minimal treatment-associated morbidity, and, as such, provides an attractive alternative to open surgery for carefully selected cases. A large number of gamma knife- and linear accelerator-based clinical series have now been published, documenting high long-term (5- to 10-year) meningioma control rates and low morbidity. Certain meningioma locations are known to be associated with higher risk for surgical morbidity, including cavernous sinus, tentorium, posterior fossa, and posterior sagittal sinus. In addition, meningioma surgery appears to involve higher morbidity in the elderly. Many neurosurgeons now consider radiosurgery to be the treatment of choice for small meningiomas in high-risk locations or in the elderly.

KEYWORDS

Radiosurgery - linear accelerator - meningioma

REFERENCES

• 1 Leksell L. The stereotaxic method and radiosurgery of the brain.  Acta Chir Scand . 1951;  102 316-319
• 2 Betti O O, Derechinsky V E. Hyperselective encephalic irradiation with a linear accelerator.  Acta Neurochir Suppl (Wien) . 1984;  33 385-390
• 3 Colombo F, Benedetti A, Pozza F. et al . External stereotactic irradiation by linear accelerator.  Neurosurgery . 1985;  16 154-160
• 4 Friedman W A, Bova F J. The University of Florida radiosurgery system.  Surg Neurol . 1989;  32 334-342
• 5 Friedman W A, Buatti J M, Bova F J, Mendenhall W M. LINAC Radiosurgery: A Practical Guide.  Berlin: Springer-Verlag; 1998
• 6 Foote K D, Friedman W A, Buatti J M, Bova F J, Meeks S A. Linear accelerator radiosurgery in brain tumor management.  Neurosurg Clin North Am . 1999;  10 203-242
• 7 Aichholzer M, Bertalanffy A, Dietrich W. et al . Gamma knife radiosurgery of skull base meningiomas.  Acta Neurochir (Wien) . 2000;  142 647-652
• 8 Flickinger J C, Kondziolka D, Maitz A H, Lunsford L D. Gamma knife radiosurgery of imaging-diagnosed intracranial meningiomas.  Int J Radiat Oncol Biol Phys . 2003;  56 801-806
• 9 Iwai Y, Yamanaka K, Ishiguro T. Gamma knife radiosurgery for the treatment of cavernous sinus meningiomas.  Neurosurgery . 2003;  52 517-524
• 10 Kondziolka D, Lunsford L D, Coffey R J, Flickinger J C. Stereotactic radiosurgery of meningiomas.  J Neurosurg . 1991;  74 552-559
• 11 Kondziolka D, Flickinger J C, Perez B. Judicious resection and/or radiosurgery for parasagittal meningiomas: outcomes from a multicenter review. Gamma Knife Meningioma Study Group.  Neurosurgery . 1998;  43 405-413
• 12 Kurita H, Sasaki T, Kawamoto S. et al . Role of radiosurgery in the management of cavernous sinus meningiomas.  Acta Neurol Scand . 1997;  96 297-304
• 13 Lee J Y, Niranjan A, McInerney J, Kondziolka D, Flickinger J C, Lunsford L D. Stereotactic radiosurgery providing long-term tumor control of cavernous sinus meningiomas.  J Neurosurg . 2002;  97 65-72
• 14 Liscak R, Simonova G, Vymazal J, Janouskova L, Vladyka V. Gamma knife radiosurgery of meningiomas in the cavernous sinus region.  Acta Neurochir (Wien) . 1999;  141 473-480
• 15 Muthukumar N, Kondziolka D, Lunsford L D, Flickinger J C. Stereotactic radiosurgery for tentorial meningiomas.  Acta Neurochir (Wien) . 1998;  140 315-320
• 16 Muthukumar N, Kondziolka D, Lunsford L D, Flickinger J C. Stereotactic radiosurgery for anterior foramen magnum meningiomas.  Surg Neurol . 1999;  51 268-273
• 17 Nicolato A, Ferraresi P, Foroni R. et al . Gamma knife radiosurgery in skull base meningiomas.  Stereotact Funct Neurosurg . 1996;  66 112-120
• 18 Nicolato A, Foroni R, Pellegrino M. et al . Gamma knife radiosurgery in meningiomas of the posterior fossa. Experience with 62 treated lesions.  Minim Invasive Neurosurg . 2001;  44 211-217
• 19 Nicolato A, Foroni R, Alessandrini F, Bricolo A, Gerosa M. Radiosurgical treatment of cavernous sinus meningiomas: experience with 122 treated patients.  Neurosurgery . 2002;  51 1153-1161
• 20 Ojemann S G, Sneed P K, Larson D A. et al . Radiosurgery for malignant meningioma: results in 22 patients.  J Neurosurg . 2000;  93 (suppl 3) S62-S67
• 21 Pendl G, Schrottner O, Friehs G M, Feichtinger H. Stereotactic radiosurgery of skull base meningiomas.  Stereotact Funct Neurosurg . 1995;  64 11-18
• 22 Pendl G, Eustacchio S, Unger F. Radiosurgery as alternative treatment for skull base meningiomas.  J Clin Neurosci . 2001;  8 (suppl 1) S12-S14
• 23 Roche P H, Regis J, Dufour H. et al . Gamma knife radiosurgery in the management of cavernous sinus meningiomas.  J Neurosurg . 2000;  93 (suppl 3) S68-S73
• 24 Sekhar L N, Jannetta P J, Burkhart L E, Janosky J E. Meningiomas involving the clivus: a six-year experience with 41 patients.  Neurosurgery . 1990;  27 764-781
• 25 Subach B R, Lunsford L D, Kondziolka D, Maitz A H, Flickinger J C. Management of petroclival meningiomas by stereotactic radiosurgery.  Neurosurgery . 1998;  42 437-443
• 26 Tanaka T, Kobayashi T, Kida Y. Growth control of cranial base meningiomas by stereotactic radiosurgery with a gamma knife unit.  Neurol Med Chir (Tokyo) . 1996;  36 7-10
• 27 Engenhart R, Kimmig B N, Hover K H. et al . Stereotactic single high dose radiation therapy of benign intracranial meningiomas.  Int J Radiat Oncol Biol Phys . 1990;  19 1021-1026
• 28 Valentino V, Schinaia G, Raimondi A J. The results of radiosurgical management of 72 middle fossa meningiomas.  Acta Neurochir. (Wien) . 1993;  122 60-70
• 29 Chang S D, Adler J R. Treatment of cranial base meningiomas with linear accelerator radiosurgery.  Neurosurgery . 1997;  41 1019-1027
• 30 Chang S D, Adler Jr R J, Martin D P. LINAC radiosurgery for cavernous sinus meningiomas.  Stereotact Funct Neurosurg . 1998;  71 43-50
• 31 Colombo F, Francescon P. Clinical linear accelerator radiosurgery. In: Gildenberg PL, Tasker RR, eds. Textbook of Stereotactic and Functional Neurosurgery New York: McGraw-Hill 1998: 757-762
• 32 Hakim R, Alexander III E, Loeffler J S. et al . Results of linear accelerator-based radiosurgery for intracranial meningiomas.  Neurosurgery . 1998;  42 446-454
• 33 Shafron D H, Friedman W A, Buatti J M, Bova F J, Mendenhall W M. LINAC radiosurgery for benign meningiomas.  Int J Radiat Oncol Biol Phys . 1999;  43 321-327
• 34 Villavicencio A T, Black P M, Shrieve D C, Fallon M P, Alexander E, Loeffler J S. Linac radiosurgery for skull base meningiomas.  Acta Neurochir (Wien) . 2001;  143 1141-1152
• 35 Spiegelmann R, Friedman W A. The radiosurgical treatment of meningiomas. In: Schmidek HM, ed. Meningiomas and Their Surgical Management Philadelphia: WB Saunders 1991: 508-516
• 36 Spiegelmann R, Nissim O, Menhel J, Alezra D, Pfeffer M R. Linear accelerator radiosurgery for meningiomas in and around the cavernous sinus.  Neurosurgery . 2002;  51 1373-1380
• 37 Ojemann R G. Meningiomas: Clinical features and surgical management. In: Wilkins RH, Rengachary SS, eds. Neurosurgery New York: McGraw-Hill 1985: 635-654
• 38 Sekhar L N, Altschuler E M. Meningiomas of the cavernous sinus. In: Al-Mefty O, ed. Meningiomas New York: Raven Press 1991: 445-460
• 39 Sekhar L N, Swamy K S, Jaiswal V. Surgical excision of meningiomas involving the clivus: preoperative and intraoperative features as predictors of postoperative functional deterioration.  J Neurosurg . 1994;  81 860-868
• 40 Awad I A, Kalfas I, Hahn J F. Intracranial meningiomas in the aged: Surgical outcome in the era of computed tomography.  Neurosurgery . 1989;  24 557-560
• 41 Djindjian M, Caron J P, Athayde A A, Ferrier M. Intracranial meningiomas in the elderly (over 70 years old). A retrospective study of 30 surgical cases.  Acta Neurochir (Wien). . 1988;  90 121-123