Wei Zhishuo, Mallela Arka N, Faramand Andrew, Niranjan Ajay, Lunsford L Dade
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Neurosurg Case Lessons. 2021 May 17;1(20):CASE21116. doi: 10.3171/CASE21116.
Invasive sagittal sinus meningiomas are difficult tumors to cure by resection alone. Stereotactic radiosurgery (SRS) can be used as an adjuvant management strategy to improve tumor control after incomplete resection.
The authors reported the long-term retrospective follow-up of two patients whose recurrent parasagittal meningiomas eventually occluded their superior sagittal sinus. Both patients underwent staged radiosurgery and fractionated radiation therapy to achieve tumor control that extended to 20 years after their initial surgery. After initial subtotal resection of meningiomas that had invaded major cerebral venous sinuses, adjuvant radiosurgery was performed to enhance local tumor control. Over time, adjacent tumor progression required repeat SRS and fractionated radiation therapy to boost long-term tumor response. Staged multimodality intervention led to extended survival in these patients with otherwise unresectable meningiomas.
Multimodality management with radiosurgery and fractionated radiation therapy was associated with long-term survival of two patients with otherwise surgically incurable and invasive meningiomas of the dural venous sinuses.
侵袭性矢状窦脑膜瘤是仅通过手术切除难以治愈的肿瘤。立体定向放射外科（SRS）可作为一种辅助治疗策略，以改善不完全切除术后的肿瘤控制。
作者报告了两名复发性矢状窦旁脑膜瘤最终阻塞上矢状窦患者的长期回顾性随访情况。两名患者均接受了分期放射外科和分次放射治疗，以实现肿瘤控制，该控制在初次手术后持续了20年。在对侵犯大脑主要静脉窦的脑膜瘤进行初次次全切除后，进行辅助放射外科以增强局部肿瘤控制。随着时间的推移，相邻肿瘤进展需要重复SRS和分次放射治疗以提高长期肿瘤反应。分期多模式干预使这些原本无法切除的脑膜瘤患者的生存期延长。
放射外科和分次放射治疗的多模式管理与两名患有其他情况下无法手术治愈的硬脑膜静脉窦侵袭性脑膜瘤患者的长期生存相关。
