Abstract
Background : Various modalities of stereotactic radiosurgery (SRS) have been proven to be effective and safe in the treatment of intracranial meningiomas. Depending on the characteristics of each modality, various results can be obtained. To analyze the therapeutic effect of hypofractionated SRS (hSRS) on skull base meningioma, we retrospectively reviewed the results of clinical and follow-up image studies.
 Materials and Methods : Between January 2011 and December 2020, thirty-two patients (median age, 58 years; 5 males and 27 females) had been treated with hSRS using the Novalis Tx system for skull base meningiomas (mean volume, 7.86 cm3). Tumor was located in most frequently cavernous sinus (n = 7, 21.9%), cerebellopontine angle (n = 7, 21.9%), clinoidal (n = 6, 18.8%) locations. Thirteen patients had previously undergone surgical treatment including radiosurgery. The median cumulative dose was 25 Gy (range, 21.0-27.5 Gy) in five fractions (range, 3-5 fractions).
 Results : During a median follow-up of 50 months (range, 13-98 months) hSRS achieves 100% tumor control rate in all patients without tumor progression. As a result of volumetric analysis using magnetic resonance imaging showed partial response (volume decrease > 20%) in 26 patients (81.3%), stable in 4 patients (12.5%). The tumor volume decreased by an average of 55.5% when compared with the beginning.
 Conclusions : This study showed that hSRS is an effective and safe treatment modality with a high tumor control rate and functional outcomes for skull base meningioma.
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