Introduction: Petroclival meningiomas represent a common yet challenging clinical identity. Long-term outcome of petroclival meningiomas after stereotactic radiosurgery (SRS) is lacking. We reviewed the imaging and clinical outcomes of petroclival meningioma patients with minimum of 10 years of follow up after SRS.
Methods: Eighty patients (62 female, 77.5%; median age, 53 years) with petroclival meningioma who underwent SRS from 1987 and 2010 at University of Pittsburgh Medical Center (UPMC) and a minimal follow-up of 10 years were included. The median KPS score at SRS was 80 (60-100). Thirty-six (45%) patients had prior partial surgical resection. The most common presenting symptoms included cranial neuropathy (51 patients, 63.75%), and gait imbalance (27 patients, 33.75%). The median cumulative tumor volume was 4.5 cc (range 0.85-21.4). Radiosurgery was performed with a median margin dose of 13 Gy (range 10 – 20 Gy) prescribed to a 50% isodose line. The median 12Gy volume was 4.78 cc (range 1.1-19.1).
Results: The 15-, 20- and 25-year overall survival (OS) was 86.03%, 68.19% and 54.25%. In total, 7 patients (8.75%) had local tumor progression at a median of 13 years (range: 1– 24) after SRS. The 10- and 15- year local tumor control rates were 98.73% and 83.42%, respectively. Twenty-eight patients (35%) had 20% or more tumor volumetric reduction at the latest radiographic imaging follow up. No patient reported any symptoms related to adverse radiation effect (ARE). Twenty-five patients (31.25%) experienced symptomatic improvements. Four patients (5%) had delayed onset of new symptoms related to tumor progression. During follow-up, 6 patient underwent repeat SRS, and 1 patient underwent additional resection.
Conclusion : In this long-term follow up study, patients with petroclival meningiomas had excellent tumor control rates that extended even beyond 10 years after SRS.
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