{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:20:42Z","timestamp":1790778042195,"version":"4.1.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,5]]},"abstract":"\nObject<\/jats:title>\nBecause of their critical location adjacent to brain, cranial nerve, and vascular structures, petroclival meningiomas remain a clinical challenge. The authors evaluated outcomes in 168 patients with petroclival meningiomas who underwent Gamma Knife surgery (GKS) during a 21-year interval.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nGamma Knife surgery was used as either primary or adjuvant treatment of 168 petroclival meningiomas involving the region between the petrous apex and the upper two-thirds of the clivus. The most common presenting symptoms were trigeminal nerve dysfunction, balance problems, diplopia, and hearing loss. The median tumor volume was 6.1 cm3<\/jats:sup> (range 0.3\u201332.5 cm3<\/jats:sup>), and the median radiation dose to the tumor margin was 13 Gy (range 9\u201318 Gy).<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nDuring a median follow-up of 72 months, neurological status improved in 44 patients (26%), remained stable in 98 (58%), and worsened in 26 (15%). Tumor volume decreased in 78 patients (46%), remained stable in 74 (44%), and increased in 16 (10%), all of whom were subjected to additional management strategies. Overall 5- and 10-year progression-free survival rates were 91 and 86%, respectively. Patients followed up for at least 10 years (31 patients) had tumor and symptom control rates of 97 and 94%, respectively. Eight patients had repeat radiosurgery, 4 underwent delayed resection, and 4 had fractionated radiation therapy. Cerebrospinal fluid diversion was performed in 7 patients (4%). Significant risk factors for tumor progression were a tumor volume \u2265 8 cm3<\/jats:sup> (p = 0.001) and male sex (p = 0.02).<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nIn this 21-year experience, GKS for petroclival meningiomas obviated initial or further resection in 98% of patients and was associated with a low risk of adverse radiation effects. The authors believe that radiosurgery should be considered as an initial option for patients with smaller-volume, symptomatic petroclival meningiomas.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.8.jns09695","type":"journal-article","created":{"date-parts":[[2009,9,4]],"date-time":"2009-09-04T14:09:23Z","timestamp":1252073363000},"page":"957-964","source":"Crossref","is-referenced-by-count":133,"title":["Long-term control of petroclival meningiomas through radiosurgery"],"prefix":"10.3171","volume":"112","author":[{"given":"Thomas J.","family":"Flannery","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Department of Neurosurgery, Royal Hospitals Belfast, Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Kano","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Radiation Oncology, University of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sait","family":"Sirin","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Tormenti","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Radiation Oncology, University of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Radiation Oncology, University of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120957","series-title":"Neurosurgery","first-page":"56","article-title":"Longterm recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation","volume":"64","author":"Aghi","year":"2009"},{"key":"b2-1120957","series-title":"Neurosurgery","first-page":"510","article-title":"Petrosal approach for petroclival meningiomas","volume":"22","author":"Al-Mefty","year":"1988"},{"issue":"6 Suppl","key":"b3-1120957","series-title":"Neurosurgery","first-page":"1182","article-title":"Evolution of surgical approaches in the treatment of petroclival meningiomas: a retrospective 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