[Comparison of methods of treatment of meningiomas invading the superior sagittal sinus]. / Sravnitel'naya otsenka metodov lecheniya meningiom, invaziruyushchikh verkhnii sagittal'nyi sinus.
Zh Vopr Neirokhir Im N N Burdenko
; 87(5): 69-77, 2023.
Article
em En, Ru
| MEDLINE
| ID: mdl-37830471
ABSTRACT
There are various approaches to the treatment of patients with parasagittal meningiomas. OBJECTIVE:
To optimize treatment strategy for meningiomas invading the superior sagittal sinus. MATERIAL ANDMETHODS:
The study included 87 patients with benign parasagittal meningiomas between 2010 and 2012. Of these, 34 patients underwent surgery alone, 27 - radiotherapy, 26 - surgery and subsequent radiotherapy. Both groups were comparable in male-to-female ratio, age and localization of tumors in relation to superior sagittal sinus. The follow-up period was at least 5 years. We analyzed the effect of treatment on neurological status, Karnofsky score and tumor growth control.RESULTS:
Mean volume of tumors was 43.3 cm3 in patients undergoing surgery and 6.7 cm3 in the radiotherapy group. In the combined treatment group, mean volume was 65.8 cm3 before surgery and 8.8 cm3 before irradiation. General cerebral symptoms (84%), epileptic seizures (37%) and movement disorders (31%) prevailed. Surgery provided the best results in patients with small meningiomas (<14 cm3) causing focal neurological symptoms. Isolated radiotherapy was the most effective in asymptomatic patients. Large tumors required surgery with adjuvant irradiation.CONCLUSION:
Benign parasagittal meningiomas followed by focal neurological symptoms require surgical intervention regarding the best functional outcomes and tumor growth control. Radiotherapy without surgery is advisable for progressive asymptomatic tumors. Resection followed by irradiation is preferable if total resection without the risk of damage to veins and cortex is impossible.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Radiocirurgia
/
Neoplasias Meníngeas
/
Meningioma
Limite:
Female
/
Humans
/
Male
Idioma:
En
/
Ru
Revista:
Zh Vopr Neirokhir Im N N Burdenko
Ano de publicação:
2023
Tipo de documento:
Article