Image-guided multisession radiosurgery of skull base meningiomas

Alfredo Conti, Antonio Pontoriero, Giuseppe Iatì, Salvatore M. Cardali, Anna Brogna, Filippo Friso, Vittoria Rosetti, Matteo Zoli, Silvana Parisi, Alberto Cacciola, Sara Lillo, Stefano Pergolizzi, Diego Mazzatenta

Research output: Contribution to journalArticlepeer-review


Background: The efficacy of single-session stereotactic radiosurgery (sSRS) for the treatment of intracranial meningioma is widely recognized. However, sSRS is not always feasible in cases of large tumors and those lying close to critically radiation-sensitive structures. When surgery is not recommended, multi-session stereotactic radiosurgery (mSRS) can be applied. Even so, the efficacy and best treatment schedule of mSRS are not yet established. The aim of this study is to validate the role of mSRS in the treatment of skull base meningiomas. Methods: A retrospective analysis of patients with skull base meningiomas treated with mSRS (two to five fractions) at the University of Messina, Italy, from 2008 to 2018, was conducted. Results: 156 patients met the inclusion criteria. The median follow-up period was 36.2 ± 29.3 months. Progression-free survival at 2-, 5-, and 10-years was 95%, 90%, and 80.8%, respectively. There were no new visual or motor deficits, nor cranial nerves impairments, excluding trigeminal neuralgia, which was reported by 5.7% of patients. One patient reported carotid occlusion and one developed brain edema. Conclusion: Multisession radiosurgery is an effective approach for skull base meningiomas. The long-term control is comparable to that obtained with conventionally-fractionated radiotherapy, while the toxicity rate is very limited.

Original languageEnglish
Article number3569
Pages (from-to)1-16
Number of pages16
Issue number12
Publication statusPublished - Dec 2020


  • CyberKnife
  • Hypofractionated stereotactic radiotherapy
  • Image-guided radiotherapy
  • Meningioma
  • Radiosurgery
  • Skull base

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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