Turkish Neurosurgery
Stereotactic Radiosurgery after Subtotal Resection of Critically-Located Grade I Meningioma: A Single-Center Experience and Review of Literature
Burak Karaaslan1, Emrah Çeltici2, Erkut Baha Bulduk3, Alp Özgün Börcek2, Gökhan Kurt2, Memduh Kaymaz2, Şükrü Aykol2, Hakan Emmez2
1Çubuk Halil Şıvgın State Hospital, Department of Neurosurgery, ANKARA,
2Gazi University Faculty of Medicine, Department of Neurosurgery, ANKARA,
3Medicana International Hospital, Department of Neurosurgery, ANKARA,
DOI: 10.5137/1019-5149.JTN.30181-20.2

Aim:Meningiomas are extra-axial and the most common benign intracranial tumors. Although microsurgery is the primary treatment modality for these lesions, in some cases, complete resection is not safe because of surrounding vital structures. In this study, we aimed to analyze the results of stereotactic radiosurgery in 295 patients with residual Grade I meningiomas located at parasellar region, petroclival region, cerebellopontine angle and parasagittal region.Material and Methods:295 patients with Grade 1 residual Meningiomas (197 women, 98 men), who were treated by adjuvant radiosurgery in Gazi University Gamma Knife Center between 2004-2015 were analyzed. WHO Grade 2and 3 meningiomas were not included in our study. Minimum radiological follow-up was 24 months. The median follow-up was 54 months. The tumor volume, location, treatment dose, morbidity, progression free survival and tumor control rate were analyzed.Results:The median tumor volume was 5.2 cm3 (0.04-39.7), median age was 50(20-80), median dose was 14 Gy and tumor control rate was 94.5% (stationary in 85.0%, volume reduction in 9.5%). Increase in tumor volume was seen in 16 patients (5.5%) and re-operation was performed in 5 of them (1.6%). Stereotactic radiosurgery was performed again for 8 patients (2.7%).The location of the tumors was as follows: 39.3% parasellar region, 20% cerebellopontine angle, 13.6% petroclival and 27.1% was parasagittal, falcine or convexity. Major morbidities were detected in 6 (2%) patients. Minor morbidities were detected in 18 (6.1%) patients.Conclusion:Stereotactic radiosurgery is an effective and safe treatment modality for residual Grade I meningiomas.

Corresponding author : Burak Karaaslan