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Clinical Research
Available online 5 March 2023
Cerebellopontine angle meningiomas: LINAC stereotactic radiosurgery treatment
Meningiomas de ángulo pontocerebeloso: tratamiento con radiocirugía mediante LINAC
Isabel M. Ortiz Garcíaa,
Corresponding author

Corresponding author.
, Ana M. Jorques Infantea, Nicolás Cordero Tousa, Julio Almansa Lópezb, José Expósito Hernándezc, Gonzalo Olivares Granadosa
a Neurocirugía, Hospital Universitario Virgen de las Nieves, Granada, Spain
b Servicio de Radiofísica, Hospital Universitario Virgen de las Nieves, Granada, Spain
c Oncología Radioterápica, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Received 08 June 2022. Accepted 21 December 2022
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To evaluate the efficacy of treatment with linear accelerator-based stereotactic radiosurgery (LINAC) in cerebellopontine angle meningiomas.


We analyzed 80 patients diagnosed with cerebellopontine angle meningiomas between 2001 and 2014, treated with stereotactic radiosurgery (SRS), of whom 81.9% (n=68) were women, with an average age of 59.1 years (32–79). SRS was applied as primary treatment in 83.7% (n=67) and in 16.3% (n=13) as an adjuvant treatment to surgery. SRS treatment was provided using LINAC (Varian 600, 6MeV) with M3 micromultilamines (brainLab) and stereotactic frame. The average tumor volume was 3.12cm3 (0.34–10.36cm3) and the coverage dose was 14Gy (12–16Gy). We performed a retrospective descriptive analysis and survival analysis was performed with the Kaplan–Meier method and multivariate analysis to determine those factors predictive of tumor progression or clinical improvement.


After an average follow-up period of 86.9 months (12–184), the tumor control rate was 92.8% (n=77). At the end of the study, there was an overall reduction in tumor volume of 32.8%, with an average final volume of 2.11cm3 (0–10.35cm3). The progression-free survival rate at 5, 10 and 12 years was 98%, 95% and 83.3% respectively. The higher tumor volume (p=0.047) was associated with progression. There was clinical improvement in 26.5% (n=21) of cases and clinical worsening in 16.2% (n=13). Worsening is related to the radiation dose received by the brainstem (p=0.02). Complications were 8.7% (7 cases) of hearing loss, 5% (4 cases) of brain radionecrosis, and 3.7% (3 cases) of cranial nerve V neuropathy. Hearing loss was related to initial tumor size (p=0.033) and maximum dose (p=0.037). The occurrence of radionecrosis with the maximum dose (p=0.037).


Treatment of cerebellopontine angle meningiomas with single-dose SRS using LINAC is effective in the long term. Better tumor control rates were obtained in patients with small lesions.

Cerebellopontine angle

Evaluar el resultado del tratamiento con radiocirugía estereotáctica (RC) mediante acelerador lineal (LINAC) en meningiomas de ángulo pontocerebeloso (APC).


Analizamos 80 pacientes diagnosticados de meningiomas de APC entre los años 2001–2014, tratados mediante RC. El 81,9% (n=68) fueron mujeres, con una media de edad de 59,1 años (32–79). La RC se aplicó como tratamiento primario en el 83,7% (n=67), y en el 16,3% (n=13) como adyuvante a la cirugía. El tratamiento con RC se lleva a cabo en un acelerador lineal (Varian 600, 6MeV) con micromultiláminas M3 (BrainLab) y marco estereotáxico. El volumen tumoral medio fue de 3,14cm3 (0,34–10,36cm3) y la dosis de cobertura media fue de 14 Gy (12–16Gy). Se realiza un análisis descriptivo retrospectivo, un análisis de supervivencia método Kaplan-Meier y se contrasta la relación entre las variables del estudio mediante análisis univariados.


Tras un periodo de seguimiento medio de 86,9 meses (12–184), la tasa de control tumoral fue del 92,8% (n=77). Se comprobó una reducción global del volumen tumoral al final del estudio del 32,8%, con un volumen medio final de 2,11cm3 (0–10,35cm3). La tasa de supervivencia libre de progresión fue del 98% al año, del 95% a los 5 años y del 83,3% a los 10 y 12 años. El mayor volumen tumoral previo al tratamiento (p=0,047) se relacionó con la progresión. Se produjo la mejoría clínica en el 26,5% (n=21) de los casos y el deterioro en el 16,2% (n=13); el empeoramiento se relaciona con la dosis de radiación que recibe el troncoencéfalo (p=0,02). Respecto a las complicaciones, el 8,7% (n=7) sufrieron deterioro de la audición, el 5% (n=4) radionecrosis y el 3,7% (n=3) neuropatía del V par craneal. La dosis máxima alcanzada (p=0,037) y el tamaño tumoral inicial (p=0,033) se relacionan con la progresión de la hipoacusia, y el desarrollo de radionecrosis, con la dosis máxima alcanzada (p=0,037).


El tratamiento con RC mediante LINAC en meningiomas de ángulo pontocerebeloso es eficaz a largo plazo, obteniendo las mejores tasas de control tumoral en aquellos pacientes con lesiones de menor tamaño.

Palabras clave:
Ángulo pontocerebeloso


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