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• W2155132797 abstract "Post-treatment peritumoral brain edema is a known and potentially serious risk of single fraction radiosurgery for meningiomas. Purported high risk factors include increased tumor volume, dose, pre-treatment edema, and tumor location. A recent review, classifying tumor location as basal (e.g.,, cavernous sinus) or nonbasal (e.g.,, parasagittal, convexity), found that edema rates varied from 0-22% with basal lesions, and from 25-71% with nonbasal lesions.1 We review the risk of edema after single fraction and multisession stereotactic radiosurgery. We reviewed the records of patients treated for benign and atypical intracranial meningioma at our institution using stereotactic radiosurgery (SRS). 87 lesions were treated in 81 patients from April 2002 to August 2008. Patients were 24 men and 57 women with a mean age of 61 years (range 29-90). 35 patients were treated for recurrence or progression after surgery. 52 lesions were basally located and 35 were non-basal. Mean lesion size was 11.3 mL (0.6-98.2 mL). Radiation was delivered using a frameless robotic stereotactic radiosurgery system in single fraction or multisession treatments (typically 3-5 fractions), with a median of 2500 cGy in 5 fractions. Clinical and radiographic follow-up were reviewed for symptomatic and asymptomatic edema. With a median follow-up of 19 months, 81 lesions were assessable for treatment response. Symptomatic edema developed in 2 cases (2.5%) and asymptomatic edema developed in 3 cases (3.7%). Four of 78 (5%) of the lesions treated with multisession SRS developed edema, one case of which was symptomatic. 4 of 35 (11%) of nonbasal lesions developed edema, whereas 1/52 (2%) of basal lesions developed edema. On univariate analysis, single fraction treatment (p < 0.05) and nonbasal location (p = 0.08) were significant/borderline significant as risk factors for any edema. Significance was lost on multivariate analysis. For symptomatic edema, pre-treatment edema and single fraction treatment were significant risk factors on multivariate analysis (p < 0.01 for both). Location, prior radiation, recurrence and volume were not significant. Local control rate was 90% in evaluable patients, with tumor regression in 15 cases (19%). Rates of peritumoral brain edema following multisession SRS were low, even in patients with large tumor volumes and high risk locations. Multisession SRS edema rates may approach the low edema rates seen with conventionally fractionated radiotherapy. Multisession SRS merits consideration in patients at risk for post-treatment edema." @default.
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• W2155132797 date "2009-11-01" @default.
• W2155132797 modified "2023-09-26" @default.
• W2155132797 title "Multisession Stereotactic Radiosurgery for Meningioma Results in Low Rates of Post-treatment Edema" @default.
• W2155132797 doi "https://doi.org/10.1016/j.ijrobp.2009.07.557" @default.
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