Stereotactic radiosurgery for asymptomatic petroclival region meningiomas: a focused analysis from the IMPASSE study

Georgios Mantziaris, Stylianos Pikis, Adomas Bunevicius, Selcuk Peker, Yavuz Samanci, Ahmed M. Nabeel, Wael A. Reda, Sameh R. Tawadros, Amr M.N. El-Shehaby, Khaled Abdelkarim, Reem M. Emad, Violaine Delabar, David Mathieu, Cheng chia Lee, Huai che Yang, Roman Liscak, Jaromir Hanuska, Roberto Martinez Alvarez, Nuria Martinez Moreno, Manjul TripathiHerwin Speckter, Camilo Albert, Greg N. Bowden, Ronald J. Benveniste, Dev N. Patel, Douglas Kondziolka, Kenneth Bernstein, L. Dade Lunsford, Jason Sheehan

Research output: Contribution to journalArticlepeer-review


Background: The optimal management of asymptomatic, petroclival meningiomas remains incompletely defined. The purpose of this study was to evaluate the safety and efficacy of upfront stereotactic radiosurgery (SRS) for patients with asymptomatic, petroclival region meningiomas. Methods: This retrospective, international, multicenter study involved patients treated with SRS for an asymptomatic, petroclival region meningioma. Study endpoints included local tumor control rate, procedural complications, and the emergence of new neurological deficits. Results: There were 72 patients (22 males, mean age 59.53 years (SD ± 11.9)) with an asymptomatic meningioma located in the petroclival region who were treated with upfront SRS. Mean margin dose and maximum dose were 13.26 (SD ± 2.72) Gy and 26.14 (SD ± 6.75) Gy respectively. Median radiological and clinical follow-up periods post-SRS were 52.5 (IQR 61.75) and 47.5 months (IQR 69.75) respectively. At last follow-up, tumor control was achieved in all patients. SRS-related complications occurred in 6 (8.33%) patients, with 3 of them (4.17%) exhibiting new neurological deficits. Conclusions: Upfront SRS for asymptomatic, petroclival region meningiomas affords excellent local tumor control and does so with a relatively low risk of SRS-related complications. SRS can be considered at diagnosis of an asymptomatic petroclival region meningioma. If active surveillance is initially chosen, SRS should be recommended when growth is noted during radiological follow-up.

Original languageEnglish (US)
JournalActa Neurochirurgica
StateAccepted/In press - 2021
Externally publishedYes


  • Asymptomatic
  • Meningioma
  • Petroclival region
  • Radiosurgery
  • Stereotactic

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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