{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:04:03Z","timestamp":1791515043292,"version":"4.3.4"},"reference-count":19,"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":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Stereotactic radiosurgery (SRS) has proven to be a safe and effective treatment for many patients with intracranial meningiomas. Nevertheless, the morbidity associated with radiosurgery of larger meningiomas is poorly understood.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors performed a retrospective review of 116 patients who underwent SRS for meningiomas (WHO Grade I) &gt; 10 cm<jats:sup>3<\/jats:sup> between 1990 and 2007, with a minimum follow-up of 12 months. Patients with atypical or malignant meningiomas and those who received prior radiotherapy were excluded. The average tumor volume was 17.5 cm<jats:sup>3<\/jats:sup> (range 10.1\u201348.6 cm<jats:sup>3<\/jats:sup>); the average tumor margin dose was 15.1 Gy (range 12\u201318 Gy); and the mean follow-up duration was 70.1 months (range 12\u2013199 months).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Tumor control was 99% at 3 years and 92% at 7 years after radiosurgery. Thirty complications after radiosurgery were noted in 27 patients (23%), including 7 cases of seizures, 6 cases of hemiparesis, 5 cases of trigeminal injury, 4 cases of headaches, 3 cases of diplopia, 2 cases each of cerebral infarction and ataxia, and 1 case of hearing loss. Patients with supratentorial tumors experienced a higher complication rate compared with patients with skull base tumors (44% compared with 18%) (hazard ratio 2.9, 95% CI 1.3\u20136.7, p = 0.01).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The morbidity associated with SRS for patients with benign meningiomas &gt; 10 cm<jats:sup>3<\/jats:sup> is greater for supratentorial tumors compared with skull base tumors. Whereas radiosurgery is relatively safe for patients with large-volume skull base meningiomas, resection should remain the primary disease management for the majority of patients with large-volume supratentorial meningiomas.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.8.jns09703","type":"journal-article","created":{"date-parts":[[2009,9,18]],"date-time":"2009-09-18T14:54:05Z","timestamp":1253285645000},"page":"951-956","source":"Crossref","is-referenced-by-count":61,"title":["Radiosurgery for large-volume (&gt; 10 cm3) benign meningiomas"],"prefix":"10.3171","volume":"112","author":[{"given":"Jonathan M.","family":"Bledsoe","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Stafford","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Park","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Radiation Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120951","series-title":"Neurosurgery","first-page":"1115","article-title":"Surgery for extraaxial tumors of the cerebral convexity and midline","volume":"62","author":"Black","year":"2008"},{"key":"b2-1120951","series-title":"J Neurosurg","first-page":"30","article-title":"Patterns of skull base meningioma progression after failed radiosurgery","volume":"106","author":"Couldwell","year":"2007"},{"key":"b3-1120951","series-title":"Neurosurgery","first-page":"915","article-title":"Long-term follow-up of patients with meningiomas involving the cavernous sinus: recurrence, progression, and quality of life","volume":"39","author":"De Jesus","year":"1996"},{"key":"b4-1120951","series-title":"J Neurosurg","first-page":"245","article-title":"Outcome of aggressive removal of cavernous sinus meningiomas","volume":"81","author":"DeMonte","year":"1994"},{"key":"b5-1120951","series-title":"Int J Radiat Oncol Biol Phys","first-page":"485","article-title":"Complications from arteriovenous malformation radiosurgery: multivariate analysis and risk modeling","volume":"38","author":"Flickinger","year":"1997"},{"key":"b6-1120951","series-title":"J Neurosurg","first-page":"195","article-title":"Postoperative irradiation for subtotally resected meningiomas. 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Gamma Knife Meningioma Study Group","volume":"43","author":"Kondziolka","year":"1998"},{"key":"b11-1120951","series-title":"J Neurosurg","first-page":"458","article-title":"Stereotactic radiosurgery for convexity meningiomas. 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