Christ Sebastian M, Farhadi Dara S, Junzhao Sun, Mahadevan Anand, Thormann Maximilian, Lam Fred C, Yu Xin, Kasper Ekkehard M
Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
University of Arizona College of Medicine - Phoenix, Phoenix, Arizona.
Adv Radiat Oncol. 2022 Oct 31;8(1):101098. doi: 10.1016/j.adro.2022.101098. eCollection 2023 Jan-Feb.
Primary stereotactic radiosurgery for intraventricular meningiomas remains controversial owing to the potential for life-threatening peritumoral edema and lack of long-term follow-up data. We review the literature and present the largest series to assess efficacy and safety of primary stereotactic radiosurgery.
A systematic review of the literature for primary stereotactic radiosurgery for intraventricular meningiomas was conducted. The retrospective series presented here comprised 33 patients who received primary stereotactic radiosurgery between 1999 and 2015 for a radiologically detected intraventricular meningioma. Demographic, diagnostic, and therapeutic data were extracted from medical records, imaging, and treatment-planning systems. Both standalone and pooled analysis were performed.
The mean patient age was 53 years, and 24 patients (73%) were female. The median Karnofsky performance status pretreatment was 80 (range, 60-100). The majority of lesions were located in the lateral ventricles (n = 32; 97%). The mean tumor volume was 8.7 cm (range, 0.6-44.55 cm). The mean delivered dose was 1390.9 cGy. Complete imaging follow-up data were available for 21 patients (64%). Of those, 14 (67%) showed partial or marginal response, 7 (33%) had stable disease, and no patient progressed per Response Assessment in Neuro-Oncology criteria. On last follow-up, 32 patients (97%) had significant improvement in performance status and a decrease in pretreatment symptoms. No high-grade Common Terminology Criteria for Adverse Events (version 5.0) toxicity was observed with the dose range employed.
Primary stereotactic radiosurgery for intraventricular meningiomas shows excellent treatment efficacy and low toxicity in patients with a long follow-up period. The best therapeutic algorithm remains to be established leveraging further clinical investigation.
由于存在危及生命的瘤周水肿风险且缺乏长期随访数据，原发性立体定向放射外科治疗脑室内脑膜瘤仍存在争议。我们回顾文献并呈现最大规模的系列病例，以评估原发性立体定向放射外科治疗的疗效和安全性。
对原发性立体定向放射外科治疗脑室内脑膜瘤的文献进行系统回顾。这里呈现的回顾性系列病例包括33例患者，他们在1999年至2015年间因影像学检查发现的脑室内脑膜瘤接受了原发性立体定向放射外科治疗。从病历、影像学和治疗计划系统中提取人口统计学、诊断和治疗数据。进行了单独分析和汇总分析。
患者的平均年龄为53岁，24例患者（73%）为女性。治疗前卡氏功能状态评分中位数为80（范围60 - 100）。大多数病变位于侧脑室（n = 32；97%）。平均肿瘤体积为8.7 cm³（范围0.6 - 44.55 cm³）。平均给予剂量为1390.9 cGy。21例患者（64%）有完整的影像学随访数据。其中，14例（67%）显示部分或边缘反应，7例（33%）病情稳定，按照神经肿瘤学反应评估标准，无患者病情进展。在最后一次随访时，32例患者（97%）的功能状态有显著改善，治疗前症状减轻。在所采用的剂量范围内，未观察到高级别不良事件通用术语标准（第5.0版）毒性反应。
原发性立体定向放射外科治疗脑室内脑膜瘤在长期随访的患者中显示出优异的治疗效果和低毒性。最佳治疗方案仍有待通过进一步的临床研究来确定。
