Intra-operative extracorporeal irradiation of tumour-invaded craniotomy bone flap in meningioma: a case series
-
Published:2024-05-24
Issue:1
Volume:166
Page:
-
ISSN:0942-0940
-
Container-title:Acta Neurochirurgica
-
language:en
-
Short-container-title:Acta Neurochir
Author:
Cook William H.ORCID, Burton Katherine, Jefferies Sarah J., Duke Simon L., Jena Rajesh, Burnet Neil G., Kirollos Ramez W., Helmy Adel E., Santarius Thomas
Abstract
Abstract
Background
Extracorporeal irradiation of tumorous calvaria (EITC) can be performed to restore function and form of the skull after resection of bone-invasive meningioma. We sought to examine the rate of tumour recurrence and other selected outcomes in patients undergoing meningioma resection and EITC.
Methods
Retrospective single-centre study of adult patients undergoing meningioma resection and EITC between January 2015 and November 2022 at a tertiary neurosurgical centre. Patient demographics, surgery data, tumour data, use of adjuvant therapy, surgical complications, and tumour recurrences were collected.
Results
Eighteen patients with 11 (61%) CNS WHO grade 1, 6 (33%) grade 2, and 1 (6%) grade 3 meningiomas were included. Median follow-up was 42 months (range 3–88). Five (28%) patients had a recurrence, but none were associated with the bone flap. Two (11%) wound infections requiring explant surgery occurred. Six (33%) patients required a further operation. Two operations were for recurrences, one was for infection, one was a washout and wound exploration but no evidence of infection was found, one patient requested the removal of a small titanium implant, and one patient required a ventriculoperitoneal shunt for a persistent CSF collection. There were no cases of bone flap resorption and cosmetic outcome was not routinely recorded.
Conclusion
EITC is feasible and fast to perform with good outcomes and cost-effectiveness compared to other reconstructive methods. We observed similar recurrence rates and lower infection rates requiring explant compared to the largest series of cranioplasty in meningioma. Cosmetic outcome is universally under-reported and should be reported in future studies.
Publisher
Springer Science and Business Media LLC
Reference32 articles.
1. Agha RA, Sohrabi C, Mathew G, Franchi T, Kerwan A, O’Neill N, Thoma A, Beamish AJ, Noureldin A, Rao A, Vasudevan B, Challacombe B, Perakath B, Kirshtein B, Ekser B, Pramesh CS, Laskin DM, Machado-Aranda D, Pagano D, Roy G, Kadioglu H, Nixon IJ, Mukhejree I, McCaul JA, Chi-Yong Ngu J, Albrecht J, Rivas JG, Raveendran K, Derbyshire L, Ather MH, Thorat MA, Valmasoni M, Bashashati M, Chalkoo M, Teo NZ, Raison N, Muensterer OJ, Bradley PJ, Goel P, Pai PS, Afifi RY, Rosin RD, Coppola R, Klappenbach R, Wynn R, Surani S, Giordano S, Massarut S, Raja SG, Basu S, Enam SA, Manning TG, Cross T, Karanth VK, Mei Z (2020) The PROCESS 2020 guideline: updating consensus preferred reporting of case series in surgery (PROCESS) guidelines. Int J Surg 84:231–235. https://doi.org/10.1016/j.ijsu.2020.11.005 2. Alkhaibary A, Alharbi A, Alnefaie N, Oqalaa Almubarak A, Aloraidi A, Khairy S (2020) Cranioplasty: a comprehensive review of the history, materials, surgical aspects, and complications. World Neurosurg 139:445–452. https://doi.org/10.1016/j.wneu.2020.04.211 3. Bianchi F, Signorelli F, Di Bonaventura R, Trevisi G, Pompucci A (2019) One-stage frame-guided resection and reconstruction with PEEK custom-made prostheses for predominantly intraosseous meningiomas: technical notes and a case series. Neurosurg Rev 42:769–775. https://doi.org/10.1007/s10143-019-01104-5 4. Cabraja M, Klein M, Lehmann T-N (2009) Long-term results following titanium cranioplasty of large skull defects. Neurosurg Focus 26:E10. https://doi.org/10.3171/2009.3.FOCUS091 5. Carolus A, Weihe S, Schmieder K, Brenke C (2017) One-step CAD/CAM titanium cranioplasty after drilling template-assisted resection of intraosseous skull base meningioma: technical note. Acta Neurochir 159:447–452. https://doi.org/10.1007/s00701-016-3053-4
|
|