Functional outcome of patients with benign meningioma treated by 3D conformal irradiation with a combination of photons and protons.

Abstract

PURPOSE:

To evaluate efficacy and tolerance of external fractionated combination of photon and proton radiation therapy (RT) for intracranial benign meningiomas.

METHODS AND MATERIALS:

Between 1994 and 2002, 51 patients with intracranial meningiomas of the base of the skull were treated with a combination of photon and proton RT. Median total dose was 60.6 cobalt Gy equivalent (54-64). One hundred eight eye-related symptoms were collected; 80 other symptoms were noted and followed up.

RESULTS:

Mean follow-up was 25.4 months. Acute tolerance was excellent. Out of the 108 eye-related symptoms, 106 (96%) were evaluated. Improvements were reported for 73 (68.8%) of them. Out of the 88 other miscellaneous symptoms, 81 (92%) were evaluated. Improvements were reported in 54 cases (67%). Median time to improvement ranged from 1 to 24 months after completion of the radiotherapy, depending on the symptom. We did not observe any worsening of primary clinical signs. Radiologically, 1 patient relapsed 4 months after the end of irradiation. Pathology revealed a malignant (Grade 3) transformation of the initial Grade 1 meningioma. Four-year local control and overall survival rates were, respectively, 98% and 100%. Stabilization of the tumor was observed in 38 cases (72%), volume reduction in 10 cases (20%), and intratumor necrosis in 3 cases. Two patients complained of Grade 3 side effects: 1 unilateral hearing loss requiring aid and 1 case of complete pituitary deficiency.

CONCLUSION:

These results stressed the clinical efficacy of fractionated-associated photon-proton RT in the treatment of meningiomas, especially on cranial nerve palsies, without severe toxicity in almost all patients.

• Authors: Georges Noël, Marc A Bollet, Valentin Calugaru, Loïc Feuvret, Christine Haie-Meder, Frédéric Dhermain, Régis Ferrand, Gilbert Boisserie, Anne Beaudré, Jean-Jacques Mazeron, Jean-Louis Habrand
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 62 Issue 5 Pg. 1412-22 (Aug 01 2005) ISSN: 0360-3016 [Print] United States
• PMID: 16029801 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Protons

Topics

• Adolescent
• Adult
• Aged
• Child
• Dose Fractionation, Radiation
• Exophthalmos (radiotherapy)
• Female
• Humans
• Male
• Meningeal Neoplasms (physiopathology, radiotherapy)
• Meningioma (physiopathology, radiotherapy)
• Middle Aged
• Photons (therapeutic use)
• Proton Therapy
• Radiotherapy, Conformal (adverse effects, methods)
• Visual Acuity