{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:52:56Z","timestamp":1781650376485,"version":"3.54.5"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018719","name":"Koc University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018719","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the long-term efficacy and safety of single-fraction Gamma Knife radiosurgery (GKRS) for pineal region meningiomas (PMs) and to clarify its role as both a primary and adjuvant treatment strategy for this anatomically challenging tumor location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 44 consecutive adults with PMs treated with single-fraction GKRS. Diagnosis was established histopathologically after prior surgery or by predefined MRI criteria with consensus neuroradiological review. Tumor response was assessed volumetrically on serial contrast-enhanced MRI, with regression, stability, and progression defined as \u2265\u200920% decrease, &lt;\u200920% change, and \u2265\u200920% increase in tumor volume, respectively. Local control (LC), progression-free survival (PFS), overall survival (OS), adverse radiation effects (AREs), and Karnofsky Performance Scale (KPS) outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median clinical and radiological follow-up were 90 and 88 months, respectively. At last radiological follow-up, LC was achieved in 42 of 44 patients (95.5%), including regression in 13 (29.5%) and stability in 29 (65.9%). Kaplan-Meier LC rates were 100% at 2 years, 97.1% at 5 years, and 86.3% at 10 years. PFS rates were 100%, 94.1%, and 72.6% at 2, 5, and 10 years, respectively. AREs occurred in 3 patients (6.8%), all without permanent sequelae. KPS remained stable or improved in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Single-fraction GKRS provides durable tumor control with low toxicity and preserved neurological function in PMs, supporting its use as a primary treatment strategy in selected patients. Preliminary adjuvant results are encouraging but require validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-026-05566-8","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:37:08Z","timestamp":1776184628000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-fraction Gamma Knife radiosurgery for pineal region meningiomas: a retrospective single-center cohort of 44 patients"],"prefix":"10.1007","volume":"177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2535-9832","authenticated-orcid":false,"given":"Ali Haluk","family":"Duzkalir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8323-8932","authenticated-orcid":false,"given":"Dogu Cihan","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7126-6373","authenticated-orcid":false,"given":"Mehmet Orbay","family":"Askeroglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-3355","authenticated-orcid":false,"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"5566_CR1","doi-asserted-by":"publisher","first-page":"586","DOI":"10.3171\/jns.1996.85.4.0586","volume":"85","author":"AN Konovalov","year":"1996","unstructured":"Konovalov AN, Spallone A, Pitzkhelauri DI (1996) Meningioma of the pineal region: a surgical series of 10 cases. J Neurosurg 85:586\u2013590. https:\/\/doi.org\/10.3171\/jns.1996.85.4.0586","journal-title":"J Neurosurg"},{"key":"5566_CR2","doi-asserted-by":"publisher","first-page":"e723","DOI":"10.1016\/j.wneu.2018.12.013","volume":"123","author":"G de Blasco Garc\u00eda","year":"2019","unstructured":"de Blasco Garc\u00eda G, Delgado-Fern\u00e1ndez J, Penanes Cuesta JR et al (2019) Meningiomas Originated at the Falcotentorial Region: Analysis of Topographic and Diagnostic Features Guiding an Optimal Surgical Planning. World Neurosurg 123:e723\u2013e733. https:\/\/doi.org\/10.1016\/j.wneu.2018.12.013","journal-title":"World Neurosurg"},{"key":"5566_CR3","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1186\/s12883-020-01783-4","volume":"20","author":"L Yu","year":"2020","unstructured":"Yu L, Orazmyradov B, Qi S et al (2020) Reinvestigation of the origins of pineal meningiomas based on its related veins and arachnoid membranes. BMC Neurol 20:200. https:\/\/doi.org\/10.1186\/s12883-020-01783-4","journal-title":"BMC Neurol"},{"key":"5566_CR4","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.pjnns.2014.09.009","volume":"48","author":"A Nowak","year":"2014","unstructured":"Nowak A, Dziedzic T, Czernicki T et al (2014) Falcotentorial and velum interpositum meningiomas: two distinct entities of the pineal region. Neurol Neurochir Pol 48:397\u2013402. https:\/\/doi.org\/10.1016\/j.pjnns.2014.09.009","journal-title":"Neurol Neurochir Pol"},{"key":"5566_CR5","doi-asserted-by":"publisher","first-page":"630","DOI":"10.3171\/2019.4.JNS19208","volume":"133","author":"X Zhao","year":"2020","unstructured":"Zhao X, Belykh E, Przybylowski CJ et al (2020) Surgical treatment of falcotentorial meningiomas: a retrospective review of a single-institution experience. J Neurosurg 133:630\u2013641. https:\/\/doi.org\/10.3171\/2019.4.JNS19208","journal-title":"J Neurosurg"},{"key":"5566_CR6","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/B978-0-12-822198-3.00033-1","volume":"170","author":"CL Dalle Ore","year":"2020","unstructured":"Dalle Ore CL, Magill ST, McDermott MW (2020) Falcotentorial meningiomas. Handb Clin Neurol 170:107\u2013114. https:\/\/doi.org\/10.1016\/B978-0-12-822198-3.00033-1","journal-title":"Handb Clin Neurol"},{"key":"5566_CR7","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1080\/02688699845041","volume":"12","author":"MJ Chandy","year":"1998","unstructured":"Chandy MJ, Damaraju SC (1998) Benign tumours of the pineal region: a prospective study from 1983 to 1997. Br J Neurosurg 12:228\u2013233. https:\/\/doi.org\/10.1080\/02688699845041","journal-title":"Br J Neurosurg"},{"key":"5566_CR8","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/s0090-3019(03)00573-1","volume":"61","author":"A Raco","year":"2004","unstructured":"Raco A, Agrillo A, Ruggeri A et al (2004) Surgical options in the management of falcotentorial meningiomas: report of 13 cases. Surg Neurol 61:157\u2013164 discussion 164. https:\/\/doi.org\/10.1016\/s0090-3019(03)00573-1","journal-title":"Surg Neurol"},{"key":"5566_CR9","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1007\/s10143-024-03069-6","volume":"47","author":"W He","year":"2024","unstructured":"He W, Chen Z, Xu C et al (2024) Twelve-year experience of pineal region meningiomas: long-term outcomes of maximal safe resection. Neurosurg Rev 47:822. https:\/\/doi.org\/10.1007\/s10143-024-03069-6","journal-title":"Neurosurg Rev"},{"key":"5566_CR10","doi-asserted-by":"publisher","first-page":"e12910","DOI":"10.1111\/jpi.12910","volume":"75","author":"F Gagliardi","year":"2023","unstructured":"Gagliardi F, De Domenico P, Garbin E et al (2023) Primary Gamma Knife Radiosurgery for pineal region tumors: A systematic review and pooled analysis of available literature with histological stratification. J Pineal Res 75:e12910. https:\/\/doi.org\/10.1111\/jpi.12910","journal-title":"J Pineal Res"},{"key":"5566_CR11","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s11060-022-04125-1","volume":"161","author":"HM Abdallah","year":"2023","unstructured":"Abdallah HM, Mallela AN, Wei Z et al (2023) Gamma Knife radiosurgery for meningiomas of the confluence of the falx and tentorium. J Neurooncol 161:225\u2013233. https:\/\/doi.org\/10.1007\/s11060-022-04125-1","journal-title":"J Neurooncol"},{"key":"5566_CR12","doi-asserted-by":"publisher","first-page":"4078","DOI":"10.1118\/1.3438081","volume":"37","author":"SH Benedict","year":"2010","unstructured":"Benedict SH, Yenice KM, Followill D et al (2010) Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 37:4078\u20134101. https:\/\/doi.org\/10.1118\/1.3438081","journal-title":"Med Phys"},{"key":"5566_CR13","doi-asserted-by":"publisher","first-page":"CNS28","DOI":"10.2217\/cns-2018-0007","volume":"8","author":"UN Chukwueke","year":"2019","unstructured":"Chukwueke UN, Wen PY (2019) Use of the Response Assessment in Neuro-Oncology (RANO) criteria in clinical trials and clinical practice. CNS Oncol 8:CNS28. https:\/\/doi.org\/10.2217\/cns-2018-0007","journal-title":"CNS Oncol"},{"key":"5566_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000177622","volume":"87","author":"D-Y Yang","year":"2009","unstructured":"Yang D-Y, Sheehan J, Liu Y-S et al (2009) Analysis of factors associated with volumetric data errors in gamma knife radiosurgery. Stereotact Funct Neurosurg 87:1\u20137. https:\/\/doi.org\/10.1159\/000177622","journal-title":"Stereotact Funct Neurosurg"},{"key":"5566_CR15","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1227\/01.NEU.0000344642.98597.A7","volume":"64","author":"A Qui\u00f1ones-Hinojosa","year":"2009","unstructured":"Qui\u00f1ones-Hinojosa A, Chang EF, Chaichana KL, McDermott MW (2009) Surgical considerations in the management of falcotentorial meningiomas: advantages of the bilateral occipital transtentorial\/transfalcine craniotomy for large tumors. Neurosurgery 64:260\u2013268 discussion 268. https:\/\/doi.org\/10.1227\/01.NEU.0000344642.98597.A7","journal-title":"Neurosurgery"},{"key":"5566_CR16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1054\/jocn.2001.0870","volume":"1","author":"N Okami","year":"2001","unstructured":"Okami N, Kawamata T, Hori T, Takakura K (2001) Surgical treatment of falcotentorial meningioma. J Clin Neurosci 8 Suppl 1:15\u201318. https:\/\/doi.org\/10.1054\/jocn.2001.0870","journal-title":"J Clin Neurosci 8 Suppl"},{"key":"5566_CR17","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.3349\/ymj.2016.57.4.1022","volume":"57","author":"CK Hong","year":"2016","unstructured":"Hong CK, Hong JB, Park H et al (2016) Surgical Treatment for Falcotentorial Meningiomas. Yonsei Med J 57:1022\u20131028. https:\/\/doi.org\/10.3349\/ymj.2016.57.4.1022","journal-title":"Yonsei Med J"},{"key":"5566_CR18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s11060-014-1605-0","volume":"121","author":"S-H Park","year":"2015","unstructured":"Park S-H, Kano H, Niranjan A et al (2015) Gamma Knife radiosurgery for meningiomas arising from the tentorium: a 22-year experience. J Neurooncol 121:129\u2013134. https:\/\/doi.org\/10.1007\/s11060-014-1605-0","journal-title":"J Neurooncol"},{"key":"5566_CR19","doi-asserted-by":"publisher","first-page":"e437","DOI":"10.1016\/j.wneu.2018.04.066","volume":"115","author":"A Talacchi","year":"2018","unstructured":"Talacchi A, Biroli A, Hasanbelliu A, Locatelli F (2018) Surgical Management of Medial Tentorial Meningioma: Falcotentorial and Torcular. World Neurosurg 115:e437\u2013e447. https:\/\/doi.org\/10.1016\/j.wneu.2018.04.066","journal-title":"World Neurosurg"},{"key":"5566_CR20","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.jocn.2020.08.016","volume":"80","author":"Y Samanci","year":"2020","unstructured":"Samanci Y, Oktug D, Yilmaz M et al (2020) Efficacy of gamma knife radiosurgery in the treatment of intraventricular meningiomas. J Clin Neurosci 80:38\u201342. https:\/\/doi.org\/10.1016\/j.jocn.2020.08.016","journal-title":"J Clin Neurosci"},{"key":"5566_CR21","doi-asserted-by":"publisher","first-page":"47","DOI":"10.3171\/jns.2006.104.1.47","volume":"104","author":"T Goto","year":"2006","unstructured":"Goto T, Ohata K, Morino M et al (2006) Falcotentorial meningioma: surgical outcome in 14 patients. J Neurosurg 104:47\u201353. https:\/\/doi.org\/10.3171\/jns.2006.104.1.47","journal-title":"J Neurosurg"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-026-05566-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-026-05566-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-026-05566-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:02:44Z","timestamp":1781647364000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11060-026-05566-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["5566"],"URL":"https:\/\/doi.org\/10.1007\/s11060-026-05566-8","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"value":"0167-594X","type":"print"},{"value":"1573-7373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"17 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Koc University (approval no: [2022.021.IRB1.016]; date: [01\/13\/2022]).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"104"}}