Efficacy of Gamma Knife Radiosurgery in Tumor Control of Cerebellopontine Angle Meningiomas: A Systematic Review

Abstract

Abstract Background Meningiomas arising from the cerebellopontine angle are relatively uncommon, comprising only 1% of intracranial meningiomas and 6% to 15% of tumors occupying this anatomic region. Because of their intimate relationship with adjacent neurovascular structures, cerebellopontine angle (CPA) meningiomas represent a formidable surgical challenge. The morbidity and mortality associated with surgical resection of CPA meningiomas is not inconsequential. Radiosurgery has been demonstrated to provide high rates of tumor control for skull base meningiomas with acceptably low complication rates. The rarity of CPA meningiomas has limited the statistical power of previous radiosurgery series describing the outcomes for these lesions. Aim of the Work Evaluate the efficacy of gamma knife stereotactic radiosurgery (GK-SRS) in tumor control of CPA meningiomas and the effect of this control on the function of the facial muscles and hearing. Methodology This systematic review included a discussion of all available studies meeting the eligible criteria including randomized controlled studies, cohort studies, and case series and the literature of reviews. Results Mean tumor control rate was 94%, 259 cases had decreased tumor volume, 271 had stable tumor growth. Increased tumor volume occurred in 27 cases. As regard facial muscles function, 13 cases had improved function, 241 cases remained unchanged, and 8 cases experienced worse function. As regard auditory function, 25 cases had improved hearing, 256 cases remained unchanged, and 25 cases experienced worse hearing. Post GK-SRS hydrocephalus was reported in six cases, trigeminal dysfunction was reported in 114 cases, and peritumoral edema was observed in 19 cases. Conclusion GK-SRS for CPA meningiomas could be considered as a highly effective technique for the management of those lesions with acceptable rates of side effects.