Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey.
Department of Neurosurgery, Gamma Knife Center, Koç University Hospital, Istanbul, Turkey.
Neurosurg Rev. 2022 Jun;45(3):2315-2322. doi: 10.1007/s10143-022-01753-z. Epub 2022 Feb 9.
Outcomes of Gamma Knife radiosurgery (GKRS) for tuberculum sellae meningiomas (TSMs) have not been reported explicitly within any meningioma series. We present the first and largest TSM series with clinical, radiosurgical, and outcome features for 78 consecutive patients managed with GKRS. Patients who underwent GKRS for TSMs between 2005 and 2021 and had a minimum of 6 months of follow-up were included. Medical records, imaging studies, and follow-up examinations were evaluated retrospectively. A total of 78 patients with a median age of 50.5 years were included. SRS was conducted as an upfront treatment for 38 patients (48.7%). The median target volume was 1.7 cm (range, 0.1-14.6). During a median follow-up of 78.5 months, the cumulative PFS rates of the whole cohort at 1, 5, and 10 years by Kaplan-Meier analysis were 100%, 97.9%, and 94.5%, respectively. Of 47 patients with impaired vision, improvement and/or preservation of visual acuity, and visual field were achieved in 55.3% and 42.6%, respectively. No new-onset hormonal deficits were observed. Based on our data, SRS represents an effective and safe modality for unresected or recurrent/residual TSMs. SRS should be offered to patients who are not willing or not ideal candidates for surgery.
伽玛刀放射外科（GKRS）治疗鞍结节脑膜瘤（TSMs）的结果尚未在任何脑膜瘤系列中明确报道。我们首次报告了最大的 TSM 系列，该系列包含 78 例连续患者的临床、放射外科和结果特征，这些患者均接受 GKRS 治疗。纳入 2005 年至 2021 年间接受 GKRS 治疗 TSMs 且随访时间至少 6 个月的患者。回顾性评估病历、影像学研究和随访检查。共纳入 78 例患者，中位年龄为 50.5 岁。38 例患者（48.7%）行 SRS 作为一线治疗。中位靶体积为 1.7cm（范围，0.1-14.6）。中位随访 78.5 个月后，Kaplan-Meier 分析显示全组患者的累积 PFS 率在 1、5 和 10 年分别为 100%、97.9%和 94.5%。47 例视力受损患者中，55.3%和 42.6%分别实现了视力改善和/或保留以及视野改善。未观察到新发生的激素缺乏。根据我们的数据，SRS 是治疗未切除或复发性/残留 TSMs 的有效且安全的方法。对于不愿意或不适合手术的患者，应提供 SRS。
