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Gamma Knife radiosurgery of olfactory groove meningiomas provides a method to preserve subjective olfactory function

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Abstract

Anosmia is a common outcome after resection of olfactory groove meningioma(s) (OGM) and for some patients represents a significant disability. To evaluate long term tumor control rates and preservation of subjective olfaction after Gamma Knife (GK) stereotactic radiosurgery (SRS) of OGM. We performed a retrospective chart review and telephone assessments of 41 patients who underwent GK SRS between 1987 and 2008. Clinical outcomes were stratified by full, partial or no subjective olfaction, whereas tumor control was assessed by changes in volume greater or lesser than 25 %. The median clinical and imaging follow-up were 76 and 65 months, respectively. Prior to SRS, 19 (46 %) patients had surgical resections and two (5 %) had received fractionated radiation therapy. Twenty four patients (59 %) reported a normal sense of smell, 12 (29 %) reported a reduced sense of smell and five (12 %) had complete anosmia. The median tumor volume was 8.5 cm3 (range 0.6–56.1), the mean radiation dose at the tumor margin was 13 Gy (range 10–20) and the median estimated dose to the olfactory nerve was 5.1 Gy (range 1.1–18.1). At follow-up, 27 patients (66 %) reported intact olfaction (three (7 %) described return to a normal sense of smell), nine (22 %) described partial anosmia, and five (12 %) had complete anosmia. No patient reported deterioration in olfaction after SRS. Thirteen patients (32 %) showed significant tumor regression, 26 (63 %) had no further growth and two (5 %) had progressed. The progression free tumor control rates were 97 % at 1 year and 95 % at 2, 10 and 20 years. Symptomatic adverse radiation effects occurred in three (7 %) patients. Stereotactic radiosurgery provided both long term tumor control and preservation of olfaction.

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Acknowledgments

The authors thank Professor Douglas Kondziolka, MD (New York University Langone Medical Center) for significant contribution to patient management at University of Pittsburgh. This study was presented at the 2013 International Stereotactic Radiosurgery Society Congress.

Conflict of interest

Dr. Lunsford is a consultant and stock holder with AB Elekta.

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Authors and Affiliations

  1. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Abhiram Gande

  2. Department of Neurological Surgery, University of Pittsburgh Medical Center, Suite B-400, UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA, 15213, USA

    Hideyuki Kano, Seyed H. Mousavi, Ajay Niranjan, John C. Flickinger & L. Dade Lunsford

  3. University of Western Ontario, London, ON, Canada

    Gregory Bowden

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  1. Abhiram Gande
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  2. Hideyuki Kano
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  3. Gregory Bowden
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  4. Seyed H. Mousavi
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  6. John C. Flickinger
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  7. L. Dade Lunsford
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Correspondence to Hideyuki Kano.

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Gande, A., Kano, H., Bowden, G. et al. Gamma Knife radiosurgery of olfactory groove meningiomas provides a method to preserve subjective olfactory function. J Neurooncol 116, 577–583 (2014). https://doi.org/10.1007/s11060-013-1335-8

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  • DOI: https://doi.org/10.1007/s11060-013-1335-8

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