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<p>Recent technologic advancements have facilitated the use of hypofractionated Gamma Knife-based radiosurgery (HF-GKRS) to treat large lesions or those in eloquent areas. This study aimed to analyze the preliminary results of HF-GKRS for these meningiomas, and to determine its effectiveness and safety.&#xa0;This single-center retrospective study analyzed data of patients who underwent HF-GKRS for large meningiomas or those in eloquent areas with &gt; 6 months of follow-up. The primary outcome was progression-free survival (PFS). The secondary outcomes were neurological deterioration, post-treatment T2 signal changes following HF-GKRS, and tumor volume changes. Volumetric analysis of the tumors after treatment was also performed to assess changes in tumor size after HF-GKRS.&#xa0;Overall, 24 patients with a median follow-up period of 22 months (range: 6–49 months) were included. Among them, 18 (75%) patients had tumors in close proximity to the optic pathway, and 15 (63%) patients had large lesions (&gt; 10 cm<sup>3</sup>). The cumulative 1- and 3-year PFS rates were 100% and 92%, respectively. The cumulative 3-year rate of adverse radiation effects was 9%. Overall, 12 patients (50%) showed tumor reduction, with a median tumor reduction rate of 45% (range: 25–58%).&#xa0;Our preliminary results revealed that HF-GKRS for large meningiomas or those in eloquent areas is safe and effective, with satisfactory short- and mid-term PFS and low adverse radiation effects. Further research with more patients and longer follow-up periods is required.</p>

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Effectiveness and safety of hypofractionated gamma knife radiosurgery for large meningiomas and those adjacent to the optic pathway and brainstem: preliminary therapeutic outcomes

  • 期刊论文

  • 发表日期：

    2025年1月15日

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  • Yudai Hirano,
  • Yuki Shinya,
  • Motoyuki Umekawa,
  • Hirotaka Hasegawa,
  • Mariko Kawashima,
  • Christoph Wipplinger,
  • Tamara Wipplinger,
  • Atsuto Katano,
  • Nobuhito Saito

摘要

Recent technologic advancements have facilitated the use of hypofractionated Gamma Knife-based radiosurgery (HF-GKRS) to treat large lesions or those in eloquent areas. This study aimed to analyze the preliminary results of HF-GKRS for these meningiomas, and to determine its effectiveness and safety. This single-center retrospective study analyzed data of patients who underwent HF-GKRS for large meningiomas or those in eloquent areas with > 6 months of follow-up. The primary outcome was progression-free survival (PFS). The secondary outcomes were neurological deterioration, post-treatment T2 signal changes following HF-GKRS, and tumor volume changes. Volumetric analysis of the tumors after treatment was also performed to assess changes in tumor size after HF-GKRS. Overall, 24 patients with a median follow-up period of 22 months (range: 6–49 months) were included. Among them, 18 (75%) patients had tumors in close proximity to the optic pathway, and 15 (63%) patients had large lesions (> 10 cm3). The cumulative 1- and 3-year PFS rates were 100% and 92%, respectively. The cumulative 3-year rate of adverse radiation effects was 9%. Overall, 12 patients (50%) showed tumor reduction, with a median tumor reduction rate of 45% (range: 25–58%). Our preliminary results revealed that HF-GKRS for large meningiomas or those in eloquent areas is safe and effective, with satisfactory short- and mid-term PFS and low adverse radiation effects. Further research with more patients and longer follow-up periods is required.