Linear Accelerator Radiosurgery for Meningiomas

Abstract

Radiosurgery has been used to treat a variety of intracranial disorders, including arteriovenous malformations, metastatic brain tumors, vestibular schwannomas, and meningiomas. Radiosurgery is an outpatient treatment, with minimal treatment-associated morbidity, and, as such, provides an attractive alternative to open surgery for carefully selected cases. A large number of gamma knife– and linear accelerator–based clinical series have now been published, documenting high long-term (5-to 10-year) meningioma control rates and low morbidity. Certain meningioma locations are known to be associated with higher risk for surgical morbidity, including cavernous sinus, tentorium, posterior fossa, and posterior sagittal sinus. In addition, meningioma surgery appears to involve higher morbidity in the elderly. Many neurosurgeons now consider radiosurgery to be the treat-ment of choice for small meningiomas in high-risk locations or in the elderly.