Long-Term Follow-Up of 82 Cavernous Sinus Meningiomas Treated with Radiosurgery

Abstract

The cases of 82 patients with cavernous sinus meningioma (CSM) treated with Stereotactic Radiosurgery (SRS) at our institution from 1992 to 2005 were retrospectively reviewed. The mean follow-up time was 8.38 years. Patients’ age ranged between 16 and 78 years (mean 51). There were 35 patients who had been operated before, and two of them had been treated with fractionated radiotherapy. Twenty-three from 35 patients were surgically intervened (65.7%) and presented post-surgical morbidity. Only in 3 cases the surgery was considered complete. The patients were referred for SRS treatment due to having tumour remains or a tumour growth. The mean volume of the tumour was 17.96 (+/?13.67) cm3. All the patients had been treated with a Linear Accelerator (LINAC) using a high precision positioning and radiation system (SRS 2000) University of Florida. The clinical progress of the patients was assessed using preand post-SRS radiological imaging, post-surgical and pre-post-SRS morbidity and mortality. Tumour volume decreased significantly with RS in 61 of 82 patients (74.4%). The tumour volume remained stable 12 patients (14.6%) and only in 9 patients (11%) was there tumour growth after SRS. Of these, 5 required surgical intervention, and 7 of the 82 underwent SRS or another fractionated stereotactic radiotherapy after the RS. Morbidity due to the SRS was only seen in 14 out of the 82 patients treated with SRS, five of them recovered completely. SRS is a high precise and effective treatment with low morbidity, becoming more and more the option of choices in the treatment of cavernous sinus meningioma.