Starke Robert M, Olson Claire, Nguyen James H, Rainey Jessica, Williams Brian J, Sheehan Jason P
J Radiosurg SBRT. 2011;1(2):123-131.
Tentorial meningiomas are complex lesions that may not always be completely resected without significant morbidity or mortality. In this study, we evaluate the outcomes of tentorial meningiomas treated with Gamma Knife radiosurgery (GKRS).
We performed a retrospective review of a prospectively compiled database evaluating the outcomes of 35 patients with tentorial meningiomas treated at the University of Virginia from 1990 to 2006. There were 29 females and 6 males with a median age of 60 years (range 21-82). Twenty were treated with primary radiosurgery, and 15 patients were treated with adjuvant radiosurgery after surgical resection. Patients were assessed clinically and radiologically at routine intervals following GKRS. Kaplan-Meier analysis was used to assess tumor progression.
The mean follow-up was 5 years (range 2-16 years). The mean pre-radiosurgery tumor volume was 5.1 cc (range 0.7-27.3cc). At last follow-up, 31 patients (89%) displayed either no growth or a decrease in tumor volume. Four (11%) patients displayed an increase in volume. Kaplan Meier analysis demonstrated radiographic progression free survival at 3, 5, and 10 years to be 96%, 91%, and 73% respectively. At the last clinical follow-up, 33 patients (94%) demonstrated no change or improvement in their neurological condition and 2 patients clinically declined (6%).
GKRS offers an acceptable rate of tumor control for tentorial meningiomas, and accomplishes this with a low incidence of new or worsening neurological deficits.
小脑幕脑膜瘤是复杂的病变，若不造成显著的发病率或死亡率，可能无法完全切除。在本研究中，我们评估了伽玛刀放射外科治疗（GKRS）小脑幕脑膜瘤的疗效。
我们对一个前瞻性汇编的数据库进行了回顾性分析，该数据库评估了1990年至2006年在弗吉尼亚大学接受治疗的35例小脑幕脑膜瘤患者的疗效。其中女性29例，男性6例，中位年龄60岁（范围21 - 82岁）。20例接受了原发性放射外科治疗，15例患者在手术切除后接受了辅助放射外科治疗。GKRS后定期对患者进行临床和影像学评估。采用Kaplan-Meier分析评估肿瘤进展情况。
平均随访时间为5年（范围2 - 16年）。放射外科治疗前肿瘤平均体积为5.1立方厘米（范围0.7 - 27.3立方厘米）。在最后一次随访时，31例患者（89%）肿瘤无生长或体积减小。4例（11%）患者肿瘤体积增大。Kaplan-Meier分析显示，3年、5年和10年的影像学无进展生存率分别为96%、91%和73%。在最后一次临床随访时，33例患者（94%）神经功能状态无变化或改善，2例患者临床症状恶化（6%）。
GKRS对小脑幕脑膜瘤提供了可接受的肿瘤控制率，并以低新发或恶化神经功能缺损发生率实现了这一目标。
