Rotating gamma system radiosurgery for cavernous sinus meningiomas: experience in Han subjects of southwestern China

Keywords: meningioma, outcome, cavernous sinus, radiosurgery, skull base

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     There are different devices for stereotactic radiosurgery.
The goal of this research is to define accurately the efficacy, safety, complications, and role of Rotating Gamma System radiosurgery for treatment of cavernous sinus meningiomas especially in Han subjects.
     Between 1999 and 2004 a total of 186 patients with cavernous sinus meningiomas treated with the Rotating Gamma System radiosurgery and with at least 60 months of follow-up data were identified.
     The tumor volume ranges from 1.3 to 128.6 cm3, the median isodose line ranges from 40% to 60%, the marginal dose ranges from 7 to 18Gy, the tumor radiation dose ranges from 16 to 40Gy. Neurofunctional, ophthalmological, and neuroradiological responses were evaluated.
     All patients were followed up from 60 to 104 months with imaging exam once per year. Rotating Gamma System radiosurgery was tolerated well in these patients. Tumor effacement was observed in 24 (12.9%), and tumor regression was observed in 96 (51.6%). The tumor regression rate of long term follow-up following the Sekhar classification as Sekhar I, II, III, IVand V were 74.3%, 66.0%, 52.3%, 41.7% and 16.7%, respectively.
     This was a retrospective review.
     Rotating Gamma System radiosurgery is safe and effective in treating cavernous sinus meningiomas. Rotating Gamma System radiosurgery may serve as a primary treatment method in some or as a salvage treatment in the others. 
     However, treatment must be tailored to meet the patient''s symptoms, tumor location, tumor morphometry, and overall health.


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