TY - JOUR
T1 - Stereotactic radiosurgery for clinoid meningiomas
T2 - a multi-institutional study
AU - Bunevicius, Adomas
AU - Pikis, Stylianos
AU - Anand, Rithika Kormath
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 - 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
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
PY - 2021/10
Y1 - 2021/10
N2 - Purpose: Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas. Methods: From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas. Results: Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm3, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700, p = 0.007) and pre-SRS radiotherapy (HR = 0.004, p < 0.001) were independent predictors of better tumor control. During median visual follow-up of 48 months, visual function declined in 8% of patients. Pre-SRS visual deficit (HR = 2.938, p = 0.048) and maximal radiation dose to the optic apparatus of ≥ 10 Gy (HR = 11.297, p = 0.02) independently predicted greater risk of post-SRS visual decline. Four patients experienced new post-SRS cranial nerve V neuropathy. Conclusions: SRS allows durable control of clinoid meningiomas and visual preservation in the majority of patients. Greater radiosurgical prescription dose is associated with better tumor control. Radiation dose to the optic apparatus of ≥ 10 Gy and visual impairment before the SRS increase risk of visual deterioration.
AB - Purpose: Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas. Methods: From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas. Results: Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm3, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700, p = 0.007) and pre-SRS radiotherapy (HR = 0.004, p < 0.001) were independent predictors of better tumor control. During median visual follow-up of 48 months, visual function declined in 8% of patients. Pre-SRS visual deficit (HR = 2.938, p = 0.048) and maximal radiation dose to the optic apparatus of ≥ 10 Gy (HR = 11.297, p = 0.02) independently predicted greater risk of post-SRS visual decline. Four patients experienced new post-SRS cranial nerve V neuropathy. Conclusions: SRS allows durable control of clinoid meningiomas and visual preservation in the majority of patients. Greater radiosurgical prescription dose is associated with better tumor control. Radiation dose to the optic apparatus of ≥ 10 Gy and visual impairment before the SRS increase risk of visual deterioration.
KW - Local control
KW - Meningioma
KW - Stereotactic radiosurgery
KW - Visual outcomes
UR - http://www.scopus.com/inward/record.url?scp=85113302595&partnerID=8YFLogxK
U2 - 10.1007/s00701-021-04972-3
DO - 10.1007/s00701-021-04972-3
M3 - Article
C2 - 34427769
AN - SCOPUS:85113302595
SN - 0001-6268
VL - 163
SP - 2861
EP - 2869
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 10
ER -