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Gamma Knife radiosurgery for neurofibromatosis type 2-associated meningiomas: a 22-year patient series

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Abstract

Neurofibromatosis type 2 (NF2) is a debilitating genetic condition with potential development of multiple meningiomas. We report our experience treating a series of NF2-associated intracranial meningiomas with Gamma Knife radiosurgery (GKRS). Between 1992 and 2013, 15 consecutive patients (age 20–54 years) with 62 intracranial meningiomas were treated with single-fraction GKRS. Fifty-five percent of tumors involved the convexity or parasagittal/falx. The median prescription dose was 16 Gy (range 13–20 Gy). The median tumor diameter was 2.1 cm (range 0.7–4.5 cm). The median radiographic and clinical follow-up periods were 103 and 111 months, respectively. The 5-year and 10-year local controls were both 96 %. The disease specific survival was 93 % at 5 years and 68 % at 10 years. Fifty-three percent of patients had multiple meningiomas and received multiple GKRS treatments (range 1–7) for new or enlarging intracranial meningiomas. 11 (73 %) patients were alive at last follow-up, with 60 (97 %) tumors controlled (smaller or unchanged in size). There were 2 in-field failures, one at 1 year and the other at 3.5 years. There were no marginal failures. Major Complications after GKRS included: 1 case of radiation necrosis, 1 case of post treatment edema, and 1 case of a presumed radiation induced cavernous malformation 5 years after GKRS. GK is an effective treatment for enlarging NF2–associated meningiomas. No cases of malignant transformation or secondary malignancies were seen during the follow-up period.

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Funding

No funding was used in the making of this study.

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Authors and Affiliations

  1. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

    Brandon Birckhead

  2. Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA

    Terence T. Sio

  3. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

    Bruce E. Pollock & Michael J. Link

  4. Department of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Nadia N. Laack

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  1. Brandon Birckhead
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  2. Terence T. Sio
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  3. Bruce E. Pollock
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  4. Michael J. Link
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  5. Nadia N. Laack
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Correspondence to Nadia N. Laack.

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Brandon Birckhead and Terence T. Sio are the Co-first authors.

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Birckhead, B., Sio, T.T., Pollock, B.E. et al. Gamma Knife radiosurgery for neurofibromatosis type 2-associated meningiomas: a 22-year patient series. J Neurooncol 130, 553–560 (2016). https://doi.org/10.1007/s11060-016-2257-z

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  • DOI: https://doi.org/10.1007/s11060-016-2257-z

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