Department of Neurosurgery, Koç University School of Medicine, Istanbul, Turkey.
Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey.
Neurosurg Rev. 2021 Oct;44(5):2667-2673. doi: 10.1007/s10143-020-01446-5. Epub 2020 Nov 26.
Outcomes of 37 patients of foramen magnum meningioma (FMM) were evaluated, and the related literature was reviewed to determine the efficacy of Gamma Knife radiosurgery (GKRS) for treating patients with FMM. We present the largest series reported from a single institution with the longest follow-up to date. The database of patients who underwent GKRS for FMM between 2007 and 2019 was evaluated retrospectively. A total of 37 patients with radiological and pathological features consistent with FMM were included in this series. Thirty-three patients were female, and 4 were male. The median age was 58 years (range, 23-74 years). The most common symptom at diagnosis was headache (64.9%). Twelve patients had a history of microsurgical resection. The median duration from the initial onset of symptoms to GKRS was 12 months (range 1-140 months). Among the 37 tumors, eight (21.6%) were located ventrally, 24 (64.9%) laterally, and five (13.5%) dorsally. The median target volume was 3.30 cm (range, 0.6-17.6 cm). Thirty-five patients (95%) were treated with single fraction GKRS, and two patients (5%) were treated with hypofractionated GKRS. The median clinical follow-up was 80 months (range, 18-151 months), while the median radiological follow-up was 84 months (range, 18-144 months). At the last clinical follow-up after GKRS, 27 patients (73%) had improved symptoms, and none had worsened pre-GKRS symptoms. At the last radiological follow-up after GKRS, 23 tumors (62.2%) remained stable, 13 (35.1%) decreased in size, and 1 (2.7%) increased in size. Tumor control, including stable and regressed tumors, was achieved in 97.3% of patients. Our cohort demonstrates that GKRS is an effective and safe treatment for patients with either primary or recurrent/residual FMM.
对 37 例枕骨大孔脑膜瘤（FMM）患者的预后进行了评估，并对相关文献进行了回顾，以确定伽玛刀放射外科（GKRS）治疗 FMM 患者的疗效。我们展示了来自单一机构的最大系列报告，并具有迄今为止最长的随访时间。回顾性评估了 2007 年至 2019 年间接受 GKRS 治疗 FMM 的患者数据库。该系列共纳入 37 例影像学和病理学特征符合 FMM 的患者。33 例为女性，4 例为男性。中位年龄为 58 岁（范围 23-74 岁）。诊断时最常见的症状是头痛（64.9%）。12 例有显微切除手术史。从症状初始发作到 GKRS 的中位时间为 12 个月（范围 1-140 个月）。在 37 个肿瘤中，8 个（21.6%）位于腹侧，24 个（64.9%）位于外侧，5 个（13.5%）位于背侧。中位靶体积为 3.30cm（范围 0.6-17.6cm）。35 例（95%）患者接受单次分割 GKRS 治疗，2 例（5%）患者接受分次 GKRS 治疗。中位临床随访时间为 80 个月（范围 18-151 个月），中位影像学随访时间为 84 个月（范围 18-144 个月）。在 GKRS 后最后一次临床随访时，27 例（73%）患者症状改善，无一例患者 GKRS 前症状恶化。在 GKRS 后最后一次影像学随访时，23 个肿瘤（62.2%）稳定，13 个（35.1%）缩小，1 个（2.7%）增大。97.3%的患者肿瘤得到控制，包括稳定和消退的肿瘤。我们的队列表明，GKRS 是原发性或复发性/残留 FMM 患者的一种有效且安全的治疗方法。
