Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study

Adomas Bunevicius; Rithika Kormath Anand; Mohanad Suleiman; Ahmed M. Nabeel; Wael A. Reda; Sameh R. Tawadros; Khaled Abdelkarim; Amr M.N. El-Shehaby; Reem M. Emad; Tomas Chytka; Roman Liscak; Kimball Sheehan; Darrah Sheehan; Marco Perez Caceres; David Mathieu; Cheng Chia Lee; Huai Che Yang; Piero Picozzi; Andrea Franzini; Luca Attuati; Herwin Speckter; Jeremy Olivo; Samir Patel; Christopher P. Cifarelli; Daniel T. Cifarelli; Joshua D. Hack; Ben A. Strickland; Gabriel Zada; Eric L. Chang; Kareem R. Fakhoury; Chad G. Rusthoven; Ronald E. Warnick; Jason Sheehan

doi:10.1093/neuros/nyaa544

Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study

Adomas Bunevicius, Rithika Kormath Anand, Mohanad Suleiman, Ahmed M. Nabeel, Wael A. Reda, Sameh R. Tawadros, Khaled Abdelkarim, Amr M.N. El-Shehaby, Reem M. Emad, Tomas Chytka, Roman Liscak, Kimball Sheehan, Darrah Sheehan, Marco Perez Caceres, David Mathieu, Cheng Chia Lee, Huai Che Yang, Piero Picozzi, Andrea Franzini, Luca AttuatiHerwin Speckter, Jeremy Olivo, Samir Patel, Christopher P. Cifarelli, Daniel T. Cifarelli, Joshua D. Hack, Ben A. Strickland, Gabriel Zada, Eric L. Chang, Kareem R. Fakhoury, Chad G. Rusthoven, Ronald E. Warnick, Jason Sheehan^*

^*Corresponding author for this work

Department of Surgery

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

BACKGROUND: Stereotactic radiosurgery (SRS) is increasingly used for management of perioptic meningiomas. OBJECTIVE: To study the safety and effectiveness of SRS for perioptic meningiomas. METHODS: From 12 institutions participating in the International Radiosurgery Research Foundation (IRRF), we retrospectively assessed treatment parameters and outcomes following SRS for meningiomas located within 3 mm of the optic apparatus. RESULTS: A total of 438 patients (median age 51 yr) underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) perioptic meningiomas. Median treatment volume was 8.01 cm3. Median prescription dose was 12 Gy, and median dose to the optic apparatus was 8.50 Gy. A total of 405 patients (93%) underwent single-fraction SRS and 33 patients (7%) underwent hypofractionated SRS. During median imaging follow-up of 55.6 mo (range: 3.15-239 mo), 33 (8%) patients experienced tumor progression. Actuarial 5-yr and 10-yr progression-free survival was 96% and 89%, respectively. Prescription dose of ≥12 Gy (HR: 0.310; 95% CI [0.141-0.679], P =. 003) and single-fraction SRS (HR: 0.078; 95% CI [0.016-0.395], P =. 002) were associated with improved tumor control. A total of 31 (10%) patients experienced visual decline, with actuarial 5-yr and 10-yr post-SRS visual decline rates of 9% and 21%, respectively. Maximum dose to the optic apparatus ≥10 Gy (HR = 2.370; 95% CI [1.086-5.172], P =. 03) and tumor progression (HR = 4.340; 95% CI [2.070-9.097], P <. 001) were independent predictors of post-SRS visual decline. CONCLUSION: SRS provides durable tumor control and quite acceptable rates of vision preservation in perioptic meningiomas. Margin dose of ≥12 Gy is associated with improved tumor control, while a dose to the optic apparatus of ≥10 Gy and tumor progression are associated with post-SRS visual decline.

Original language	English
Pages (from-to)	828-837
Number of pages	10
Journal	Neurosurgery
Volume	88
Issue number	4
DOIs	https://doi.org/10.1093/neuros/nyaa544
State	Published - 1 Apr 2021

Keywords

Gamma Knife
Outcomes
Perioptic meningioma
Progression-free survival
Stereotactic radiosurgery
Visual outcomes

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Bunevicius, A., Anand, R. K., Suleiman, M., Nabeel, A. M., Reda, W. A., Tawadros, S. R., Abdelkarim, K., El-Shehaby, A. M. N., Emad, R. M., Chytka, T., Liscak, R., Sheehan, K., Sheehan, D., Caceres, M. P., Mathieu, D., Lee, C. C., Yang, H. C., Picozzi, P., Franzini, A., ... Sheehan, J. (2021). Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study. Neurosurgery, 88(4), 828-837. https://doi.org/10.1093/neuros/nyaa544

@article{848004ba4c394f5bb0cab2b1eb41ca3d,

title = "Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study",

abstract = "BACKGROUND: Stereotactic radiosurgery (SRS) is increasingly used for management of perioptic meningiomas. OBJECTIVE: To study the safety and effectiveness of SRS for perioptic meningiomas. METHODS: From 12 institutions participating in the International Radiosurgery Research Foundation (IRRF), we retrospectively assessed treatment parameters and outcomes following SRS for meningiomas located within 3 mm of the optic apparatus. RESULTS: A total of 438 patients (median age 51 yr) underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) perioptic meningiomas. Median treatment volume was 8.01 cm3. Median prescription dose was 12 Gy, and median dose to the optic apparatus was 8.50 Gy. A total of 405 patients (93%) underwent single-fraction SRS and 33 patients (7%) underwent hypofractionated SRS. During median imaging follow-up of 55.6 mo (range: 3.15-239 mo), 33 (8%) patients experienced tumor progression. Actuarial 5-yr and 10-yr progression-free survival was 96% and 89%, respectively. Prescription dose of ≥12 Gy (HR: 0.310; 95% CI [0.141-0.679], P =. 003) and single-fraction SRS (HR: 0.078; 95% CI [0.016-0.395], P =. 002) were associated with improved tumor control. A total of 31 (10%) patients experienced visual decline, with actuarial 5-yr and 10-yr post-SRS visual decline rates of 9% and 21%, respectively. Maximum dose to the optic apparatus ≥10 Gy (HR = 2.370; 95% CI [1.086-5.172], P =. 03) and tumor progression (HR = 4.340; 95% CI [2.070-9.097], P <. 001) were independent predictors of post-SRS visual decline. CONCLUSION: SRS provides durable tumor control and quite acceptable rates of vision preservation in perioptic meningiomas. Margin dose of ≥12 Gy is associated with improved tumor control, while a dose to the optic apparatus of ≥10 Gy and tumor progression are associated with post-SRS visual decline.",

keywords = "Gamma Knife, Outcomes, Perioptic meningioma, Progression-free survival, Stereotactic radiosurgery, Visual outcomes",

author = "Adomas Bunevicius and Anand, {Rithika Kormath} and Mohanad Suleiman and Nabeel, {Ahmed M.} and Reda, {Wael A.} and Tawadros, {Sameh R.} and Khaled Abdelkarim and El-Shehaby, {Amr M.N.} and Emad, {Reem M.} and Tomas Chytka and Roman Liscak and Kimball Sheehan and Darrah Sheehan and Caceres, {Marco Perez} and David Mathieu and Lee, {Cheng Chia} and Yang, {Huai Che} and Piero Picozzi and Andrea Franzini and Luca Attuati and Herwin Speckter and Jeremy Olivo and Samir Patel and Cifarelli, {Christopher P.} and Cifarelli, {Daniel T.} and Hack, {Joshua D.} and Strickland, {Ben A.} and Gabriel Zada and Chang, {Eric L.} and Fakhoury, {Kareem R.} and Rusthoven, {Chad G.} and Warnick, {Ronald E.} and Jason Sheehan",

note = "Publisher Copyright: {\textcopyright} 2021 Congress of Neurological Surgeons 2021.",

year = "2021",

month = apr,

day = "1",

doi = "10.1093/neuros/nyaa544",

language = "English",

volume = "88",

pages = "828--837",

journal = "Neurosurgery",

issn = "0148-396X",

publisher = "Lippincott Williams and Wilkins Ltd.",

number = "4",

}

Bunevicius, A, Anand, RK, Suleiman, M, Nabeel, AM, Reda, WA, Tawadros, SR, Abdelkarim, K, El-Shehaby, AMN, Emad, RM, Chytka, T, Liscak, R, Sheehan, K, Sheehan, D, Caceres, MP, Mathieu, D, Lee, CC, Yang, HC, Picozzi, P, Franzini, A, Attuati, L, Speckter, H, Olivo, J, Patel, S, Cifarelli, CP, Cifarelli, DT, Hack, JD, Strickland, BA, Zada, G, Chang, EL, Fakhoury, KR, Rusthoven, CG, Warnick, RE & Sheehan, J 2021, 'Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study', Neurosurgery, vol. 88, no. 4, pp. 828-837. https://doi.org/10.1093/neuros/nyaa544

TY - JOUR

T1 - Stereotactic Radiosurgery for Perioptic Meningiomas

T2 - An International, Multicenter Study

AU - Bunevicius, Adomas

AU - Anand, Rithika Kormath

AU - Suleiman, Mohanad

AU - Nabeel, Ahmed M.

AU - Reda, Wael A.

AU - Tawadros, Sameh R.

AU - Abdelkarim, Khaled

AU - El-Shehaby, Amr M.N.

AU - Emad, Reem M.

AU - Chytka, Tomas

AU - Liscak, Roman

AU - Sheehan, Kimball

AU - Sheehan, Darrah

AU - Caceres, Marco Perez

AU - Mathieu, David

AU - Lee, Cheng Chia

AU - Yang, Huai Che

AU - Picozzi, Piero

AU - Franzini, Andrea

AU - Attuati, Luca

AU - Speckter, Herwin

AU - Olivo, Jeremy

AU - Patel, Samir

AU - Cifarelli, Christopher P.

AU - Cifarelli, Daniel T.

AU - Hack, Joshua D.

AU - Strickland, Ben A.

AU - Zada, Gabriel

AU - Chang, Eric L.

AU - Fakhoury, Kareem R.

AU - Rusthoven, Chad G.

AU - Warnick, Ronald E.

AU - Sheehan, Jason

PY - 2021/4/1

Y1 - 2021/4/1

N2 - BACKGROUND: Stereotactic radiosurgery (SRS) is increasingly used for management of perioptic meningiomas. OBJECTIVE: To study the safety and effectiveness of SRS for perioptic meningiomas. METHODS: From 12 institutions participating in the International Radiosurgery Research Foundation (IRRF), we retrospectively assessed treatment parameters and outcomes following SRS for meningiomas located within 3 mm of the optic apparatus. RESULTS: A total of 438 patients (median age 51 yr) underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) perioptic meningiomas. Median treatment volume was 8.01 cm3. Median prescription dose was 12 Gy, and median dose to the optic apparatus was 8.50 Gy. A total of 405 patients (93%) underwent single-fraction SRS and 33 patients (7%) underwent hypofractionated SRS. During median imaging follow-up of 55.6 mo (range: 3.15-239 mo), 33 (8%) patients experienced tumor progression. Actuarial 5-yr and 10-yr progression-free survival was 96% and 89%, respectively. Prescription dose of ≥12 Gy (HR: 0.310; 95% CI [0.141-0.679], P =. 003) and single-fraction SRS (HR: 0.078; 95% CI [0.016-0.395], P =. 002) were associated with improved tumor control. A total of 31 (10%) patients experienced visual decline, with actuarial 5-yr and 10-yr post-SRS visual decline rates of 9% and 21%, respectively. Maximum dose to the optic apparatus ≥10 Gy (HR = 2.370; 95% CI [1.086-5.172], P =. 03) and tumor progression (HR = 4.340; 95% CI [2.070-9.097], P <. 001) were independent predictors of post-SRS visual decline. CONCLUSION: SRS provides durable tumor control and quite acceptable rates of vision preservation in perioptic meningiomas. Margin dose of ≥12 Gy is associated with improved tumor control, while a dose to the optic apparatus of ≥10 Gy and tumor progression are associated with post-SRS visual decline.

AB - BACKGROUND: Stereotactic radiosurgery (SRS) is increasingly used for management of perioptic meningiomas. OBJECTIVE: To study the safety and effectiveness of SRS for perioptic meningiomas. METHODS: From 12 institutions participating in the International Radiosurgery Research Foundation (IRRF), we retrospectively assessed treatment parameters and outcomes following SRS for meningiomas located within 3 mm of the optic apparatus. RESULTS: A total of 438 patients (median age 51 yr) underwent SRS for histologically confirmed (29%) or radiologically suspected (71%) perioptic meningiomas. Median treatment volume was 8.01 cm3. Median prescription dose was 12 Gy, and median dose to the optic apparatus was 8.50 Gy. A total of 405 patients (93%) underwent single-fraction SRS and 33 patients (7%) underwent hypofractionated SRS. During median imaging follow-up of 55.6 mo (range: 3.15-239 mo), 33 (8%) patients experienced tumor progression. Actuarial 5-yr and 10-yr progression-free survival was 96% and 89%, respectively. Prescription dose of ≥12 Gy (HR: 0.310; 95% CI [0.141-0.679], P =. 003) and single-fraction SRS (HR: 0.078; 95% CI [0.016-0.395], P =. 002) were associated with improved tumor control. A total of 31 (10%) patients experienced visual decline, with actuarial 5-yr and 10-yr post-SRS visual decline rates of 9% and 21%, respectively. Maximum dose to the optic apparatus ≥10 Gy (HR = 2.370; 95% CI [1.086-5.172], P =. 03) and tumor progression (HR = 4.340; 95% CI [2.070-9.097], P <. 001) were independent predictors of post-SRS visual decline. CONCLUSION: SRS provides durable tumor control and quite acceptable rates of vision preservation in perioptic meningiomas. Margin dose of ≥12 Gy is associated with improved tumor control, while a dose to the optic apparatus of ≥10 Gy and tumor progression are associated with post-SRS visual decline.

KW - Gamma Knife

KW - Outcomes

KW - Perioptic meningioma

KW - Progression-free survival

KW - Stereotactic radiosurgery

KW - Visual outcomes

UR - http://www.scopus.com/inward/record.url?scp=85102964705&partnerID=8YFLogxK

U2 - 10.1093/neuros/nyaa544

DO - 10.1093/neuros/nyaa544

M3 - Article

C2 - 33475718

AN - SCOPUS:85102964705

SN - 0148-396X

VL - 88

SP - 828

EP - 837

JO - Neurosurgery

JF - Neurosurgery

IS - 4

ER -

Stereotactic Radiosurgery for Perioptic Meningiomas: An International, Multicenter Study

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Keywords

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