Meningioma of the skull base: long-term outcome after image-guided stereotactic radiotherapy.

Abstract

PURPOSE:

The purpose of this study was to analyse the feasibility, safety, and long-term efficacy of linear accelerator-based fractionated stereotactic radiotherapy for meningiomas of the skull base. We evaluated the long-term clinical outcome of patients and identified prognostic factors after fractionated stereotactic radiotherapy.

PATIENTS AND METHODS:

Between 10/1995 and 03/2009, 136 patients with a median age of 57 years with skull base meningioma received fractionated stereotactic radiotherapy. A total of 34 patients had a grade I meningioma, in 102 cases no histology was obtained (grade 0). Fractionated stereotactic radiotherapy was delivered as primary treatment for 57 patients and postoperatively for 79. The patients received a mean total dose of 56.95 (min/max 32.4/63)Gy.

RESULTS:

Median follow-up was 44.9 months. Overall progression-free survival was 96.9% after 3 years, 93.8% after 5 years, and 91.5% after 10 years. Patients with unknown histology showed progression-free survival rates of 100%, 98.7%, and 93.5% at 3, 5, and 10 years and patients with biopsy-proven grade I meningioma showed rates of 100% after 3 years, 91.7% after 5 years and 85.9% after 10 years. Patients with adjuvant radiotherapy showed significantly worse progression-free survival rates than patients who had been treated with primary radiotherapy (P=0.043), progression-free survival rates were independent of tumour size. The most common acute grade I symptoms were headache, fatigue, and local alopecia. The most common chronic grade I symptoms were fatigue and headache.

CONCLUSIONS:

This large study showed that fractionated stereotactic radiotherapy is an effective and safe treatment modality with high progression-free survival rates for intracranial meningioma. We identified "prior surgery" as significant poor prognostic factor.

• Authors: D Kaul, V Budach, M Misch, E Wiener, S Exner, H Badakhshi
• Journal: Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique (Cancer Radiother) Vol. 18 Issue 8 Pg. 730-5 (Dec 2014) ISSN: 1769-6658 [Electronic] France
• PMID: 25307475 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Disease-Free Survival
• Feasibility Studies
• Female
• Humans
• Male
• Meningioma (radiotherapy)
• Middle Aged
• Prognosis
• Radiosurgery
• Retrospective Studies
• Skull Base Neoplasms (radiotherapy)
• Surgery, Computer-Assisted
• Time Factors
• Treatment Outcome
• Young Adult