Farrokhi M.r, Ansari Z,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Meningiomas are common benign tumors of the brain. Meningioma patients have optimal functional recovery after surgical removal of their tumors. Some patients experience recurrence months or years after surgical resection. In this study, we try to determine the prevalence of recurrent meningioma and the correlation between recurrence and certain factors.
Methods: This retrospective descriptive-analytical study included all patients with recurrent meningioma at Shiraz University of Medical Sciences-affiliated hospitals during a 20-year period (1983 to 2003). We evaluated a series of data for each patient including age, gender, tumor volume, tumor shape, bone changes, brain edema, tumor location, histological subtypes, degree of tumor resection and duration between operation and recurrence. Finally, correlations between these factors and recurrence were investigated using SPSS software version 11.5, by the descriptive method.
Results: Among the 644 patients enrolled in this study, the recurrence rate of intracranial meningioma was determined to be 9.6%. Multivariate analysis revealed a statistical correlation between edema, bone changes, tumor volume, tumor volume, tumor shape and histological subtype, but no relationship was found between age, gender and tumor location. Our study shows a statistical correlation between radiotherapy and reduced chance of recurrence. Patients with malignant and atypical meningiomas have shorter periods between surgery and recurrence than those with benign types.
Conclusion: We recommend that all patients with these prognostic factors receive adjuvant therapy and closer follow-up. In consideration of the statistical correlation between the degree of tumor removal and recurrence in this study, we suggest more complete tumor resection to decrease the risk of recurrence.
Bitara Ma, Azar M, Miri Sm, Sheikhrezai A, Alikhani M, Allahverdi M, Sharif Tabrizi A, Tayebi Meybodi A,
Volume 68, Issue 3 (6-2010)
Abstract
Background: Meningiomas are among the most common tumors of the brain. Skull base meningiomas comprise s major part of brain meningiomas. They are difficult to treat because of proximity to major vital neuro-vascular structures which makes their surgical resection hazardous and fraught with a high rate of complications. Radiosurgery is considered as an alternative efficient way to treat them, which targets the tumor and its supplying vasculature. The standard treatment consists of tumor eradication and its supplying vessels through homogeneous dose of 201 rays of cobalt
60 source.
Methods: In a case-series study, we report 230 meningiomas referred to Iraninan Gamma Knife Center, treated by radiosurgery with type C Gamma Knife. Radio-surgery was performed at a mean dose of 15 Gy and 50% isodose.
Results: Two hundred and thirty of all meningioma cases refered to our institute were skull base lesions. Eighty (35%) were new case and the rest were previously treated microsurgically one or more times. None of the patients died after treatment and the most common post-operative complications were headache (30 patients) and peri- tumoral edema (12 patients).
Conclusion: Tumoral control is defined as reduced tumor volume or as no change in tumor volume. Tumor control was achieved in 218 (95%) patients. In those who were not treated microsurgically, clinical improvement was more pronounced. Thus when suitable (favorable tumor size and absence of progressive mass effect signs) the patients could be primarily treated with Gamma knife. Other patients could be managed complementarily with radiosurgery after they are treated surgically.
