Journal of Korean Neurosurgical Society

  • 제58권4호
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  • Pages.379-384
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Peritumoral Brain Edema after Stereotactic Radiosurgery for Asymptomatic Intracranial Meningiomas : Risks and Pattern of Evolution

  • Hoe, Yeon (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Young Jae (University of Ulsan College of Medicine) ;
  • Kim, Jeong Hoon (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kwon, Do Hoon (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Chang Jin (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cho, Young Hyun (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2015.08.05
  • 심사 : 2015.10.10
  • 발행 : 2015.10.28
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초록

Objective : To investigate the risks and pattern of evolution of peritumoral brain edema (PTE) after stereotactic radiosurgery (SRS) for asymptomatic intracranial meningiomas. Methods : A retrospective study was conducted on 320 patients (median age 56 years, range 24-87 years) who underwent primary Gamma Knife radiosurgery for asymptomatic meningiomas between 1998 and 2012. The median tumor volume was 2.7 cc (range 0.2-10.5 cc) and the median follow-up was 48 months (range 24-168 months). Volumetric data sets for tumors and PTE on serial MRIs were analyzed. The edema index (EI) was defined as the ratio of the volume of PTE including tumor to the tumor volume, and the relative edema indices (rEIs) were calculated from serial EIs normalized against the baseline EI. Risk factors for PTE were analyzed using logistic regression. Results : Newly developed or increased PTE was noted in 49 patients (15.3%), among whom it was symptomatic in 28 patients (8.8%). Tumor volume larger than 4.2 cc (p<0.001), hemispheric tumor location (p=0.005), and pre-treatment PTE (p<0.001) were associated with an increased risk of PTE. rEI reached its maximum value at 11 months after SRS and decreased thereafter, and symptoms resolved within 24 months in most patients (85.7%). Conclusion : Caution should be exercised in decision-making on SRS for asymptomatic meningiomas of large volume (>4.2 cc), of hemispheric location, or with pre-treatment PTE. PTE usually develops within months, reaches its maximum degree until a year, and resolves within 2 years after SRS.

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참고문헌

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피인용 문헌

  1. Post-Treatment Edema after Meningioma Radiosurgery is a Predictable Complication vol.8, pp.5, 2015, https://doi.org/10.7759/cureus.605
  2. Incidental intracranial meningiomas: a systematic review and meta-analysis of prognostic factors and outcomes vol.142, pp.2, 2015, https://doi.org/10.1007/s11060-019-03104-3
  3. Clinical Significance of Fractional Anisotropy Measured in Peritumoral Edema as a Biomarker of Overall Survival in Glioblastoma: Evidence Using Correspondence Analysis vol.67, pp.4, 2015, https://doi.org/10.4103/0028-3886.266284
  4. Initial Gamma Knife Radiosurgery for Large or Documented Growth Asymptomatic Meningiomas: Long-Term Results From a 27-Year Experience vol.10, pp.None, 2015, https://doi.org/10.3389/fonc.2020.598582
  5. Role of gamma knife radiosurgery for recurrent or residual World Health Organization grade II and III intracranial meningiomas vol.34, pp.3, 2020, https://doi.org/10.1080/02688697.2020.1726285
  6. Ten-year follow-up after Gamma Knife radiosurgery of meningioma and review of the literature vol.162, pp.9, 2015, https://doi.org/10.1007/s00701-020-04350-5
  7. The positive effects of surgery on symptomatic stereotactic radiation-induced peritumoral brain edema: A report of three cases vol.12, pp.None, 2021, https://doi.org/10.25259/sni_111_2021
  8. MR venography in gamma knife radiosurgery for parasagittal meningiomas: A technical note with the rationale of venous protection and a review of literature vol.16, pp.2, 2015, https://doi.org/10.4103/ajns.ajns_436_20