{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:34:13Z","timestamp":1763058853882,"version":"3.41.2"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the results of the Gamma Knife radiosurgery (GKRS) for World Health Organization (WHO) grade I intracranial meningiomas after surgical resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 130 patients who were pathologically diagnosed as having WHO grade I meningiomas and who underwent post-operative GKRS were retrospectively reviewed in a single center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 130 patients, 51 patients (39.2%) presented with radiological tumor progression with a median follow-up time of 79.7 months (ranging from 24.0 to 291.3 months). The median time to radiological tumor progression was 73.4 months (ranging from 21.4 to 285.3 months), whereas 1-, 3-, 5-, and 10-year radiological progression-free survival (PFS) was 100, 90, 78, and 47%, respectively. Moreover, 36 patients (27.7%) presented with clinical tumor progression. Clinical PFS at 1, 3, 5, and 10 years was 96, 91, 84, and 67%, respectively. After GKRS, 25 patients (19.2%) developed adverse effects, including radiation-induced edema (<jats:italic>n<\/jats:italic> = 22). In a multivariate analysis, a tumor volume of \u226510 ml and falx\/parasagittal\/convexity\/intraventricular location were significantly associated with radiological PFS [hazard ratio (HR) = 1.841, 95% confidence interval (CI) = 1.018\u20133.331, <jats:italic>p<\/jats:italic> = 0.044; HR = 1.761, 95% CI = 1.008\u20133.077, <jats:italic>p<\/jats:italic> = 0.047]. In a multivariate analysis, a tumor volume of \u226510 ml was associated with radiation-induced edema (HR = 2.418, 95% CI = 1.014\u20135.771, <jats:italic>p<\/jats:italic> = 0.047). Of patients who presented with radiological tumor progression, nine were diagnosed with malignant transformation. The median time to malignant transformation was 111.7 months (ranging from 35.0 to 177.2 months). Clinical PFS after repeat GKRS was 49 and 20% at 3 and 5 years, respectively. Secondary WHO grade II meningiomas were significantly associated with a shorter PFS (<jats:italic>p<\/jats:italic> = 0.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Post-operative GKRS is a safe and effective treatment for WHO grade I intracranial meningiomas. Large tumor volume and falx\/parasagittal\/convexity\/intraventricular location were associated with radiological tumor progression. Malignant transformation was one of the main cause of tumor progression in WHO grade I meningiomas after GKRS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1094032","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T06:10:35Z","timestamp":1676268635000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Post-operative gamma knife radiosurgery for WHO grade I intracranial meningiomas: A single-center, retrospective study"],"prefix":"10.3389","volume":"14","author":[{"given":"Jinxiu","family":"Yu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiamin","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanye","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guohao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minyi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunyao","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinhui","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junyi","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"v1","DOI":"10.1093\/neuonc\/noz150","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012-2016","volume":"21","author":"Ostrom","year":"2019","journal-title":"Neurooncology."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e383","DOI":"10.1016\/S1470-2045(16)30321-7","article-title":"EANO guidelines for the diagnosis and treatment of meningiomas","volume":"17","author":"Goldbrunner","year":"2016","journal-title":"Lancet Oncol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1093\/neuros\/nyaa169","article-title":"Stereotactic radiosurgery for intracranial noncavernous sinus benign meningioma: international stereotactic radiosurgery society systematic review, meta-analysis and practice guideline","volume":"87","author":"Marchetti","year":"2020","journal-title":"Neurosurgery."},{"key":"B4","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.clon.2020.02.006","article-title":"Long-Term outcomes after linac radiosurgery for benign meningiomas","volume":"32","author":"Pou","year":"2020","journal-title":"Clin Oncol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2019.3.FOCUS1956","article-title":"Gamma knife radiosurgery for intracranial benign meningiomas: follow-up outcome in 130 patients","volume":"46","author":"Ge","year":"2019","journal-title":"Neurosurg Focus."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1093\/neuros\/nyx585","article-title":"Long-term outcomes after gamma knife radiosurgery for benign meningioma: a single institution's experience with 424 patients","volume":"83","author":"Seo","year":"2018","journal-title":"Neurosurgery."},{"key":"B7","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1093\/ons\/opx109","article-title":"Single-Fractionated stereotactic radiosurgery for intracranial meningioma in elderly patients: 25-year experience at a single institution","volume":"14","author":"Hasegawa","year":"2018","journal-title":"Oper Neurosurg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"363","DOI":"10.3171\/2014.10.JNS14198","article-title":"Gamma knife radiosurgery of large skull base meningiomas","volume":"122","author":"Starke","year":"2015","journal-title":"J Neurosurg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1227\/NEU.0b013e31822d408a","article-title":"Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients","volume":"70","author":"Santacroce","year":"2012","journal-title":"Neurosurgery."},{"key":"B10","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.wneu.2016.05.071","article-title":"Gamma knife radiosurgery in sphenopetroclival meningiomas: preliminary experience at the Iran gamma knife center","volume":"93","author":"Azar","year":"2016","journal-title":"World Neurosurg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.3171\/2010.11.JNS10112","article-title":"Gamma knife surgery for convexity, parasagittal, and falcine meningiomas","volume":"114","author":"Hasegawa","year":"2011","journal-title":"J Neurosurg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1227\/NEU.0b013e31825ea557","article-title":"Single-fraction radiosurgery of benign intracranial meningiomas","volume":"71","author":"Pollock","year":"2012","journal-title":"Neurosurgery."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.3171\/2014.2.JNS13139","article-title":"Gamma knife radiosurgery for sellar and parasellar meningiomas: a multicenter study","volume":"120","author":"Sheehan","year":"2014","journal-title":"J Neurosurg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2022.8.JNS221290","article-title":"Growth risk classification and typical growth speed of convexity, parasagittal, and falx meningiomas: a retrospective cohort study","author":"Yamada","year":"2022","journal-title":"J Neurosurg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1227\/NEU.0000000000001073","article-title":"Multisession radiosurgery for sellar and parasellar benign meningiomas: long-term tumor growth control and visual outcome","volume":"78","author":"Marchetti","year":"2016","journal-title":"Neurosurgery."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e6001","DOI":"10.7759\/cureus.6001","article-title":"Staged gamma knife radiosurgery for large skull base meningiomas","volume":"11","author":"Iwai","year":"2019","journal-title":"Cureus."},{"key":"B17","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1007\/s11604-016-0581-z","article-title":"Hypofractionated stereotactic radiotherapy (HFSRT) for who grade I anterior clinoid meningiomas (ACM)","volume":"34","author":"Demiral","year":"2016","journal-title":"Jpn J Radiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"627","DOI":"10.2176\/nmc.oa.2017-0115","article-title":"CyberKnife stereotactic radiosurgery and hypofractionated stereotactic radiotherapy as first-line treatments for imaging-diagnosed intracranial meningiomas","volume":"57","author":"Manabe","year":"2017","journal-title":"Neurol Med Chir."},{"key":"B19","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s11060-015-1838-6","article-title":"Hypofractionated stereotactic radiation therapy in skull base meningiomas","volume":"124","author":"Navarria","year":"2015","journal-title":"J Neurooncol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.wneu.2016.12.056","article-title":"Is Fractionated gamma knife radiosurgery a safe and effective treatment approach for large-volume (>10 cm3) intracranial meningiomas?","volume":"99","author":"Han","year":"2017","journal-title":"World Neurosurg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s11060-016-2181-2","article-title":"WHO grade II meningioma: a retrospective study for outcome and prognostic factor assessment","volume":"129","author":"Champeaux","year":"2016","journal-title":"J Neurooncol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"E461","DOI":"10.1093\/neuros\/nyy610","article-title":"Malignant meningioma: an international multicentre retrospective study","volume":"85","author":"Champeaux","year":"2019","journal-title":"Neurosurgery."},{"key":"B23","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1136\/jnnp.2007.121582","article-title":"Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features","volume":"79","author":"Yang","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B24","doi-asserted-by":"publisher","first-page":"601","DOI":"10.3171\/jns.2001.95.4.0601","article-title":"Predictive value of progression-associated chromosomal aberrations for the prognosis of meningiomas: a retrospective study of 198 cases","volume":"95","author":"Ketter","year":"2001","journal-title":"J Neurosurg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3171\/jns.2004.101.2.0210","article-title":"Malignant progression in meningioma: documentation of a series and analysis of cytogenetic findings","volume":"101","author":"Al-Mefty","year":"2004","journal-title":"J Neurosurg."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1093\/neuonc\/noq081","article-title":"Differential expression profiling analyses identifies downregulation of 1p, 6q, and 14q genes and overexpression of 6p histone cluster 1 genes as markers of recurrence in meningiomas","volume":"12","author":"Perez-Magan","year":"2010","journal-title":"Neurooncology."},{"key":"B27","doi-asserted-by":"publisher","first-page":"14433","DOI":"10.1038\/ncomms14433","article-title":"Integrated genomic analyses of de novo pathways underlying atypical meningiomas","volume":"8","author":"Harmanci","year":"2017","journal-title":"Nat Commun."},{"key":"B28","doi-asserted-by":"publisher","first-page":"vdaa129","DOI":"10.1093\/noajnl\/vdaa129","article-title":"Malignant transformation of WHO grade I meningiomas after surgery or radiosurgery: systematic review and meta-analysis of observational studies","volume":"2","author":"Nakasu","year":"2020","journal-title":"Neurooncol Adv."},{"key":"B29","doi-asserted-by":"publisher","first-page":"E889","DOI":"10.1093\/neuros\/nyz126","article-title":"Treatment of asymptomatic meningioma with gamma knife radiosurgery: long-term follow-up with volumetric assessment and clinical outcome","volume":"85","author":"Gupta","year":"2019","journal-title":"Neurosurgery."},{"key":"B30","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3171\/jns.2000.93.supplement_3.0057","article-title":"Early complications following gamma knife radiosurgery for intracranial meningiomas","volume":"93","author":"Singh","year":"2000","journal-title":"J Neurosurg."},{"key":"B31","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1136\/jnnp.74.2.226","article-title":"Complications after gamma knife radiosurgery for benign meningiomas","volume":"74","author":"Chang","year":"2003","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B32","doi-asserted-by":"publisher","first-page":"120","DOI":"10.3171\/sup.2006.105.7.120","article-title":"Prediction of intracranial edema after radiosurgery of meningiomas","volume":"105","author":"Novotny J","year":"2006","journal-title":"J Neurosurg."},{"key":"B33","doi-asserted-by":"publisher","first-page":"325","DOI":"10.3171\/JNS-07\/08\/0325","article-title":"Gamma knife surgery for benign meningioma","volume":"107","author":"Kollova","year":"2007","journal-title":"J Neurosurg."},{"key":"B34","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1227\/01.NEU.0000365366.53337.88","article-title":"Principal risk of peritumoral edema after stereotactic radiosurgery for intracranial meningioma is tumor-brain contact interface area","volume":"66","author":"Cai","year":"2010","journal-title":"Neurosurgery."},{"key":"B35","doi-asserted-by":"publisher","first-page":"98","DOI":"10.3340\/jkns.2012.52.2.98","article-title":"Radiation-induced intratumoral necrosis and peritumoral edema after gamma knife radiosurgery for intracranial meningiomas","volume":"52","author":"Lee","year":"2012","journal-title":"J Korean Neurosurg Soc."},{"key":"B36","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1227\/NEU.0000000000000519","article-title":"Is there a tumor volume threshold for postradiosurgical symptoms? A single-institution analysis","volume":"75","author":"Kuhn","year":"2014","journal-title":"Neurosurgery."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.3171\/2014.12.JNS141687","article-title":"Predictors of response to gamma knife radiosurgery for intracranial meningiomas","volume":"123","author":"Mansouri","year":"2015","journal-title":"J neurosurg."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1094032\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T06:10:37Z","timestamp":1676268637000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1094032\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,13]]},"references-count":37,"alternative-id":["10.3389\/fneur.2023.1094032"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1094032","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2023,2,13]]},"article-number":"1094032"}}