Gamma Knife stereotactic radiosurgery for atypical or anaplastic meningiomas

Keywords: meningioma, gamma knife, brain tumor, malignant meningioma, outcome

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     Higher grade meningiomas pose unique clinical challenges.
We reported the results of Gamma Knife stereotactic radiosurgery (GKS) for recurrent of residual WHO grade 2 and 3 meningiomas after surgical resection. ‘Not benign’ meningioma has tendency to relapse repeatedly.
     The mean age was 64 years (range, 30 - 80). All patients had had surgical resection and 10 patients had received conventional external-beam radiotherapy before GKS.
     We treated 30 cases (13 males and 17 females) of WHO grade 2 or 3 meningioma by GKS. Total number of GKS procedure was 88 for all 30 patients (1 to 10 times for each patient).
     Median follow-up time of 22 months (range, 5 – 225 months) was obtained for 20 among 30 patients. Eighteen patients among 20 were alive at the end of the follow-up time, though surgical resection was performed again in 4 patients and stereotactic radiotherapy was done in 3. Only 2 patients out of 20 died during the follow-up time. Only one patient in those two died from the brain tumor 91 month after GKS, and the other patient died from lung cancer 17 month after GKS.
     This was a retrospective review.
     Atypical and malignant meningioma is liable to relapse repeatedly. 
     Patients may survive longer with timely assessment including repeat GKS.


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