Gamma Knife Radiosurgery for Atypical and Anaplastic Meningiomas

Wei Hsin Wang, Cheng Chia Lee, Huai Che Yang, Kang Du Liu, Hsiu Mei Wu, Cheng Ying Shiau, Wan You Guo, David Hung Chi Pan, Wen Yuh Chung, Ming Teh Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


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 13Gy (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.

Original languageEnglish
Pages (from-to)557-564
Number of pages8
JournalWorld Neurosurgery
StatePublished - 1 Mar 2016


  • Anaplastic meningioma
  • Gamma Knife radiosurgery
  • Key words Atypical meningioma


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