Combined Proton and Photon Conformal Radiotherapy for Intracranial Atypical and Malignant Meningioma

Journal Article · Thu Oct 01 00:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.10.053· OSTI ID:21282039

Boskos, Christos ^[1]; Feuvret, Loic ^[1]; Hopital Pitie Salpetriere, Paris ^[2]; Noel, Georges ^[3]; Habrand, Jean-Louis ^[1]; Pommier, Pascal ^[4]; Alapetite, Claire ^[1]; Mammar, Hamid ^[5]; Ferrand, Regis ^[1]; Boisserie, Gilbert; Mazeron, Jean-Jacques ^[6]

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1. Institut Curie, Centre de Protontherapie d'Orsay, Campus Universitaire, Orsay (France)
2. France
3. Centre Paul Strauss, Strasbourg (France)
4. Centre Leon Berard, Lyon (France)
5. Centre Antoine Lacassagne, Nice (France)
6. Hopital Pitie Salpetriere, Paris (France)

Purpose: To evaluate retrospectively the efficacy of conformal fractionated radiotherapy combining proton and photon beams after primary surgery for treatment of atypical and malignant meningiomas. Patients and Methods: Between September 1999 and October 2006, 24 patients (12 male, 12 female) with histopathologically proven meningioma (atypical 19, malignant 5) received postoperative combined radiotherapy with a 201-MeV proton beam at the Centre Protontherapie d'Orsay and a high-energy photon beam. Six patients underwent gross total resection and 18 a subtotal resection. Median gross tumor volume and clinical target volume were 44.7 cm{sup 3} and 153.3 cm{sup 3}, respectively. Mean total irradiation dose was 65.01 CGE (cobalt gray equivalent), with a mean proton total dose of 34.05 CGE and a mean photon total dose 30.96 CGE. Results: The median (range) follow-up interval was 32.2 (1-72) months. The overall mean local relapse-free interval was 27.2 (10-50) months, 28.3 (10-50) months for atypical meningioma and 23 (13-33) months for malignant meningioma. Ten tumors recurred locally. One-, 2-, 3-, 4-, 5-, and 8- year local control rates for the entire group of patients were 82.9% {+-} 7.8%, 82.9% {+-} 7.8%, 61.3% {+-} 11%, 61.3% {+-} 11%, 46.7% {+-} 12.3%, and 46.7% {+-} 12.3%, respectively. One-, 2-, 3-, 4-, 5-, and 8- year overall survival rates were 100%, 95.5% {+-} 4.4%, 80.4% {+-} 8.8%, 65.3% {+-} 10.6%, 53.2% {+-} 11.6%, and 42.6% {+-} 13%, respectively. Survival was significantly associated with total dose. There was no acute morbidity of radiotherapy. One patient developed radiation necrosis 16 months after treatment. Conclusions: Postoperative combination of conformal radiotherapy with protons and photons for atypical and malignant meningiomas is a well-tolerated treatment producing long-term tumor stabilization.

• OSTI ID: 21282039
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 75, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2008.10.053; PII: S0360-3016(08)03728-0; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
DISEASE INCIDENCE
MEV RANGE 100-1000
NECROSIS
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PHOTON BEAMS
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PROTON BEAMS
PROTONS
RADIATION DOSE UNITS
RADIATION DOSES
RADIOTHERAPY
SURGERY