Treatment of Intracranial Meningioma with Linac Based Radiosurgery

Kay,  Chul Seung; Yoon,  Sei Chul; Chung,  Su Mi; Ryu,  Mi Ryung; Kim,  Yeon Sil; Suh,  Tae Suk; Choi,  Kyuho; Son,  Byung Chul; Kim,  Moon Chan

J Korean Soc Ther Radiol Oncol > Volume 19(2); 2001 > Article

Original Article

The Journal of the Korean Society for Therapeutic Radiology and Oncology 2001;19(2): 81-86.

Treatment of Intracranial Meningioma with Linac Based Radiosurgery

Chul Seung Kay, Sei Chul Yoon, Su Mi Chung, Mi Ryung Ryu, Yeon Sil Kim, Tae Suk Suh, Kyuho Choi, Byung Chul Son, Moon Chan Kim

¹Department of Radiation Oncolcogy, Cancer center, Catholic University Medical College, Seoul, Korea.
²Department of Diagnostic Radiology, Cancer center, Catholic University Medical College, Seoul, Korea.
³Department of Neurosurgery, Cancer center, Catholic University Medical College, Seoul, Korea.

ABSTRACT

PURPOSE:
To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas, we retrospectively analyzed the results of clinical and follow up CT/MRI studies. METHODS AND MATERIALS: From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients, four (20%) were male and 16 (80%) were female. Mean age was 51 years old (22~78 years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing area. RS was done for primary treatment in 6 (30%), postoperative residual lesions in 11 (55%) and regrowth after surgery in 3 (15%). Mean tumor volume was 5.72 cm3 (0.78~15.1 cm3) and secondary collimator size was 2.04 cm (1~3 cm). The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy (9~30 Gy) which was 40~90% of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked.
RESULTS:
By the follow up imaging studies, the tumor volume was reduced in 5 cases (25%), arrested growth in 14 cases (70%), and increased size in 1 case (15%). Among these responsive and stable 19 patients by imaging studies, there showed loss of contrast enhancement after CT/MRI in four patients. In clinical response, nine (45%) patients were considered improved condition, 10 (50%) patients were stable and one (5%) was worsened to be operated. This partly resulted in necrosis after surgery.
CONCLUSION:
The overall control rate of meningiomas with linac based RS was 95% by both imaging follow-up and clinical evaluation. With this results, linac based RS is considered safe and effective treatment method for meningioma.

Key Words: Meningioma, Linear accelerator, Radiosurgery