Gamma Knife Radiosurgery in the Management of Benign Skull Base Meningioma; Long-Term Outcome, Possible Prognostic Factors and Literature Review

Raef FA Hafez*, Magad S Morgan, Osama M Fahmy, Yasser Omar Riyad, Wael K Zakaria and Hamdy T Hassan

Department of Neurosurgery and Gamma Knife Center, International Medical Center, Egypt

^*Correspondance to: Raef FA Hafez 

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Abstract:

Objective: The current retrospective study reports and analyzes the clinical and radiological outcome in long-term follow-up of patients harboring benign WHO grade I skull base meningiomas after single-session gamma knife radiosurgery with the evaluation of possible prognostic factors and review of the literature. Patients and Methods: This study was conducted on 252 patients harboring benign skull base meningiomas treated by GKRS at our center between 2005 to 2015 and were followed till the end of 2019, with a median follow-up period of 102 months (range 60 to 180). There were 197 females and 55 males. The median tumor volume was 4.4 cc; the median marginal prescription radiation dose was 13.5 Gy; the median isodose line was 40%. Results: The overall tumor control rate at the last follow-up post-GKRS was 93%. Tumor progression and lost tumor control were detected in 7.14% of patients. The local tumor control progression-free rate at 3-, 5-, 10 and 12 year was 100%, 97.62%, 81.6% and 81% respectively. Conclusion: In the short and long-term, single-session GKRS provides a highly durable and favorable rate of tumor control in the management of benign medium and small size skull base meningioma with improvement or maintenance of neurological function with low morbidity. GKRS can replace a complicated surgical resection in selected patients in critical locations and, in planned combined surgical and GKRS cooperation for larger tumors provides a documented long-term tumor control of residual and recurrence. Tumor volume variable stands as a reliable long-term prognostic factor for skull base meningioma tumor control post-GKRS.

Keywords:

Gamma knife radiosurgery; Meningioma; Microsurgery; Radiosurgery; Skull base

Cite the Article:

Hafez RFA, Morgan MS, Fahmy OM, Riyad YO, Zakaria WK, Hassan HT. Gamma Knife Radiosurgery in the Management of Benign Skull Base Meningioma; Long-Term Outcome, Possible Prognostic Factors and Literature Review. World J Surg Surgical Res. 2021; 4: 1348.