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Rimal H. Dossani, Danielle Terrell, Jennifer A. Kosty, Robert C. Ross, Audrey Demand, Elizabeth Wild, Racheal Peterson, Laura B. Ngwenya, Deborah L. Benzil, and Christina Notarianni

OBJECTIVE

The objective of this study was to evaluate whether there are disparities in academic rank and promotion between men and women neurosurgeons.

METHODS

The profiles of faculty members from 50 academic neurosurgery programs were reviewed to identify years in practice, number of PubMed-indexed publications, Doctor of Philosophy (PhD) attainment, and academic rank. The number of publications at each academic rank was compared between men and women after controlling for years in practice by using a negative binomial regression model. The relationship between gender and each academic rank was also determined after controlling for clustering at the institutional level, years in practice, and number of publications.

RESULTS

Of 841 faculty members identified, 761 (90%) were men (p = 0.0001). Women represented 12% of the assistant and associate professors but only 4% of the full professors. Men and women did not differ in terms of the percentage holding a PhD, years in practice, or number of publications at any academic rank. After controlling for years in practice and clustering at the facility level, the authors found that men were twice as likely as women to be named full professor (OR 2.2, 95% CI 1.09–4.44, p = 0.03). However, when institution, years in practice, PhD attainment, h-index, and number of publications were considered, men and women were equally likely to attain full professorship (OR 0.9, 95% CI 0.42–1.93).

CONCLUSIONS

Data analysis of the top neurosurgery programs suggests that although there are fewer women than men holding positions in academic neurosurgery, faculty rank attainment does not seem to be influenced by gender.

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Bradley R. Crammond, MBiostat, Neela Janakiramanan, Mario Ganau, Deborah Verran, Laura Lippa, Jonathan Braman, and Katrin Rabiei

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Bradley R. Crammond, MBiostat, Neela Janakiramanan, Mario Ganau, Deborah Verran, Laura Lippa, Jonathan Braman, and Katrin Rabiei

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Adomas Bunevicius, Mohand Suleiman, Samir Patel, Roberto Martínez Álvarez, Nuria E. Martinez Moreno, Roman Liscak, Jaromir Hanuska, Anne-Marie Langlois, David Mathieu, Christine Mau, Catherine Caldwell, Leonard C. Tuanquin, Brad E. Zacharia, James McInerney, Cheng-Chia Lee, Huai-Che Yang, Jennifer L. Peterson, Daniel M. Trifiletti, Akiyoshi Ogino, Hideyuki Kano, Ronald E. Warnick, Anissa Saylany, Love Y. Buch, John Y. K. Lee, Ben A. Strickland, Gabriel Zada, Eric L. Chang, L. Dade Lunsford, and Jason Sheehan

OBJECTIVE

Radiation-induced meningiomas (RIMs) are associated with aggressive clinical behavior. Stereotactic radiosurgery (SRS) is sometimes considered for selected RIMs. The authors investigated the effectiveness and safety of SRS for the management of RIMs.

METHODS

From 12 institutions participating in the International Radiosurgery Research Foundation, the authors pooled patients who had prior cranial irradiation and were subsequently clinically diagnosed with WHO grade I meningiomas that were managed with SRS.

RESULTS

Fifty-two patients underwent 60 SRS procedures for histologically confirmed or radiologically suspected WHO grade I RIMs. The median ages at initial cranial radiation therapy and SRS for RIM were 5.5 years and 39 years, respectively. The most common reasons for cranial radiation therapy were leukemia (21%) and medulloblastoma (17%). There were 39 multiple RIMs (35%), the mean target volume was 8.61 ± 7.80 cm3, and the median prescription dose was 14 Gy. The median imaging follow-up duration was 48 months (range 4–195 months). RIM progressed in 9 patients (17%) at a median duration of 30 months (range 3–45 months) after SRS. Progression-free survival at 5 years post-SRS was 83%. Treatment volume ≥ 5 cm3 predicted progression (HR 8.226, 95% CI 1.028–65.857, p = 0.047). Seven patients (14%) developed new neurological symptoms or experienced SRS-related complications or T2 signal change from 1 to 72 months after SRS.

CONCLUSIONS

SRS is associated with durable local control of RIMs in the majority of patients and has an acceptable safety profile. SRS can be considered for patients and tumors that are deemed suboptimal, poor surgical candidates, and those whose tumor again progresses after removal.