Kuhn Elizabeth N, Chan Michael D, Tatter Stephen B, Ellis Thomas L
Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA. ekuhn @ wakehealth.edu
Stereotact Funct Neurosurg. 2012;90(6):365-9. doi: 10.1159/000339636. Epub 2012 Aug 23.
Radiation-induced meningiomas present a unique clinical dilemma given the fact that patients with these tumors have often received a prior full course of radiotherapy. As such, traditional radiotherapy is limited by lifetime tissue tolerances to radiation, leaving surgery and radiosurgery as attractive treatment options.
To ascertain the safety and efficacy of Gamma Knife radiosurgery as a treatment for radiation-induced meningiomas.
A retrospective chart review was conducted to identify patients who received Gamma Knife radiosurgery for a meningioma and met the criteria for this being a radiation-induced tumor. Serial imaging was used to determine the outcome of treatment and clinical notes used to assess for toxicity.
We present our series of 12 patients with radiation-induced meningiomas treated with Gamma Knife stereotactic radiosurgery over a 12-year period at our institution. With a median follow-up of 35 months, local control was 100%. Two patients experienced distant brain failure (>2 cm from previous radiosurgical volume). Two patients experienced posttreatment toxicity related to treatment-related edema. A review of data collected from the scientific literature suggests that tumor volume predicts for treatment failure of radiosurgery.
Gamma Knife radiosurgery is both a safe and effective treatment for radiation-induced meningiomas.
鉴于患有这些肿瘤的患者通常已接受过完整疗程的放疗，放射性诱发的脑膜瘤带来了独特的临床困境。因此，传统放疗受到组织对辐射的终身耐受性的限制，使得手术和放射外科成为有吸引力的治疗选择。
确定伽玛刀放射外科治疗放射性诱发脑膜瘤的安全性和有效性。
进行回顾性病历审查，以确定接受伽玛刀放射外科治疗脑膜瘤且符合放射性诱发肿瘤标准的患者。采用系列影像学检查来确定治疗结果，并通过临床记录评估毒性。
我们展示了在我们机构12年期间接受伽玛刀立体定向放射外科治疗的12例放射性诱发脑膜瘤患者的系列病例。中位随访时间为35个月，局部控制率为100%。2例患者出现远处脑功能衰竭（距先前放射外科治疗区域>2 cm）。2例患者出现与治疗相关水肿有关的治疗后毒性反应。对从科学文献中收集的数据进行回顾表明，肿瘤体积可预测放射外科治疗失败。
伽玛刀放射外科是治疗放射性诱发脑膜瘤的一种安全有效的方法。
