Fractionated conformal radiotherapy in the management of cavernous sinus meningiomas: long-term functional outcome and tumor control at a single institution.

Abstract

PURPOSE:

To evaluate long-term outcome of cavernous sinus meningioma (CSM) treated with fractionated conformal radiotherapy (FCR).

PATIENTS AND METHODS:

Fifty-three patients with CSMs (16 men [30.2%], 37 women [69.8%], aged 53 ± 13.0 years [mean ± SD]) were treated by FCR. In 28 patients (52.8%) FCR was performed as first-line treatment and in 25 patients (47.2%) as adjuvant treatment. All patients received FCR with a dose of 52.9 ± 1.8 Gy in 29.4 ± 1.0 fractions over 6 weeks. Dose per fraction was 1.9 ± 0.1 Gy. Radiotherapy was delivered stereotactically in 47 cases (88.7%) and conformally in 6 (11.3%)

RESULTS:

The median follow-up was 6.9 years (range, 3-19 years). According to Sekhar's classification, 19 patients (35.8%) were Grade 1-2, 30 patients (56.6%) were Grade 3-4, and 4 patients (7.6%) were Grade 5. Pretreatment tumor volume was determined in 46 patients, and tumor volume was 12.6 ± 8.2 cm(3). In these patients, the distance between tumor and optic apparatus was 1.62 ± 1.2 mm. Actuarial 5- and 10-year progression-free survival rates were 98.1% and 95.8%, respectively. Clinical improvement was observed in 31 patients (58.5%), and 20 patients (37.7%) remained unchanged. Radiologic response was observed in 18 patients (30.2%), and 35 patients (66.0%) showed stable lesions. Two patients (3.8%) showed tumor progression during follow-up. Transient morbidity was observed in 3 patients (5.7%) and permanent morbidity in 1 (1.9%).

CONCLUSION:

Fractionated conformal radiotherapy affords satisfactory long-term tumor control and low treatment morbidity.

• Authors: Philippe Metellus, Sachin Batra, Siddharth Karkar, Sumit Kapoor, Stephanie Weiss, Lawrence Kleinberg, Danielle Rigamonti
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 78 Issue 3 Pg. 836-43 (Nov 01 2010) ISSN: 1879-355X [Electronic] United States
• PMID: 20133076 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Cavernous Sinus (surgery)
• Disease-Free Survival
• Dose Fractionation, Radiation
• Female
• Follow-Up Studies
• Humans
• Magnetic Resonance Imaging
• Male
• Meningeal Neoplasms (pathology, radiotherapy, surgery)
• Meningioma (pathology, radiotherapy, surgery)
• Middle Aged
• Radiosurgery
• Radiotherapy, Adjuvant (methods)
• Radiotherapy, Conformal (adverse effects, methods)
• Treatment Outcome
• Tumor Burden
• Young Adult