Abstract
Purpose: Report of technical aspects, results and strategies of stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) for treatment of intracranial meningiomas. Methods: A retrospective review of intracranial meningiomas treated at UCLA from May 1991 to July 2003 was performed with emphasis on technical aspects, radiological and clinical results. 161 patients with intracranial meningiomas treated by linear accelerator (Linac) stereotactic radiation were identified. There were 33 meningiomas in 32 patients with follow-up more than 48 months. Mean patient age was 57.2 years (range 19–87). There were 25 females and 7 males. 21 patients had surgical resection prior to radiosurgery. Stereotactic radiation was the primary treatment in 12 patients. Single dose radiation to 26 lesions and 7 were treated with fractionated technique. SRS dose prescribed to the periphery of the tumor ranged from 12 to 22 Gy (mean 15 Gy), SRT dose ranged from 23 to 54 Gy (mean 48 Gy). The prescription isodose ranged from 50 to 90% for the single dose group and from 85 to 90% for the fractionated treatments. Results: Follow-up was available for 32 patients treated between 48 and 125 months (mean 72.5). Tumor growth control was achieved in 30 benign meningiomas treated with SRS (92.3%) and in 7 benign meningiomas treated with SRT (100%). Worsening of previous neurological deficit was identified in 2 patients (7.9%) treated with SRS. No complications were found in SRT patients. Conclusion: Radiosurgery has been an alternative to surgical resection of selected intracranial meningiomas. Patients with tumors not amenable to either surgery or radiosurgery are now candidates for a less invasive technique than conventional radiotherapy. The need for total/subtotal surgical resection of these tumors is being challenged by superior imaging capabilities that allow for precise and effective stereotactic radiotherapy.
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