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Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors

Abstract

Purpose: To analyze our long-term experience and prognostic factors after fractionated stereotactic radiotherapy (FSRT) in patients with benign or atypical intracranial meningioma. Methods and materials: Between January 1985 and December 2001, 317 patients with a median age of 55.7 years were treated with FSRT for intracranial meningioma. The tumor distribution was World Health Organization (WHO) Grade 1 in 48.3%, WHO Grade 2 in 8.2%, and unknown in 43.5%. Of the 317 patients, 97 underwent RT as their primary treatment, 79 underwent postoperative RT (subtotal resection in 38 and biopsy only in 41), and 141 were treated for recurrent disease. The median target volume was 33.6 cm{sup 3} (range, 1.0-412.6 cm{sup 3}). The median total dose was 57.6 Gy at 1.8 Gy/fraction five times weekly. Results: The median follow-up was 5.7 years (range, 1.2-14.3 years). The overall local tumor control rate was 93.1% (295 of 317). Of the 317 patients, 72 had a partial response on CT/MRI and 223 (70.4%) remained stable. At a median of 4.5 years after FSRT, 22 patients (6.9%) had local tumor progression on MRI. Local tumor failure was significantly greater in patients with WHO Grade 2 meningioma (p < 0.002) than in patients with WHO Grade  More>>
Authors:
Milker-Zabel, Stefanie; [1]  Zabel, Angelika; [2]  Schulz-Ertner, Daniela; [3]  Schlegel, Wolfgang; [4]  Wannenmacher, Michael; [2]  Debus, Juergen; [5]  Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)]
  1. Clinical Radiology, Radiation Therapy, University of Heidelberg, Heidelberg (Germany) and Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)
  2. Clinical Radiology, Radiation Therapy, University of Heidelberg, Heidelberg (Germany)
  3. Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)
  4. Department of Medical Physics, German Cancer Research Center, Heidelberg (Germany)
  5. Clinical Radiology, Radiation Therapy, University of Heidelberg, Heidelberg a (Germany)
Publication Date:
Mar 01, 2005
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 61; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2004.07.669; PII: S0360-3016(04)02006-1; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; FAILURES; IRRADIATION; NEOPLASMS; NMR IMAGING; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SYMPTOMS; TOXICITY
OSTI ID:
20633090
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US05R2132075985
Submitting Site:
INIS
Size:
page(s) 809-816
Announcement Date:
Oct 29, 2005

Citation Formats

Milker-Zabel, Stefanie, Zabel, Angelika, Schulz-Ertner, Daniela, Schlegel, Wolfgang, Wannenmacher, Michael, Debus, Juergen, and Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)]. Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors. United States: N. p., 2005. Web. doi:10.1016/j.ijrobp.2004.07.669.
Milker-Zabel, Stefanie, Zabel, Angelika, Schulz-Ertner, Daniela, Schlegel, Wolfgang, Wannenmacher, Michael, Debus, Juergen, & Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)]. Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors. United States. doi:10.1016/j.ijrobp.2004.07.669.
Milker-Zabel, Stefanie, Zabel, Angelika, Schulz-Ertner, Daniela, Schlegel, Wolfgang, Wannenmacher, Michael, Debus, Juergen, and Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)]. 2005. "Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors." United States. doi:10.1016/j.ijrobp.2004.07.669. https://www.osti.gov/servlets/purl/10.1016/j.ijrobp.2004.07.669.
@misc{etde_20633090,
title = {Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: Long-term experience and prognostic factors}
author = {Milker-Zabel, Stefanie, Zabel, Angelika, Schulz-Ertner, Daniela, Schlegel, Wolfgang, Wannenmacher, Michael, Debus, Juergen, and Department of Radiotherapy, German Cancer Research Center, Heidelberg (Germany)]}
abstractNote = {Purpose: To analyze our long-term experience and prognostic factors after fractionated stereotactic radiotherapy (FSRT) in patients with benign or atypical intracranial meningioma. Methods and materials: Between January 1985 and December 2001, 317 patients with a median age of 55.7 years were treated with FSRT for intracranial meningioma. The tumor distribution was World Health Organization (WHO) Grade 1 in 48.3%, WHO Grade 2 in 8.2%, and unknown in 43.5%. Of the 317 patients, 97 underwent RT as their primary treatment, 79 underwent postoperative RT (subtotal resection in 38 and biopsy only in 41), and 141 were treated for recurrent disease. The median target volume was 33.6 cm{sup 3} (range, 1.0-412.6 cm{sup 3}). The median total dose was 57.6 Gy at 1.8 Gy/fraction five times weekly. Results: The median follow-up was 5.7 years (range, 1.2-14.3 years). The overall local tumor control rate was 93.1% (295 of 317). Of the 317 patients, 72 had a partial response on CT/MRI and 223 (70.4%) remained stable. At a median of 4.5 years after FSRT, 22 patients (6.9%) had local tumor progression on MRI. Local tumor failure was significantly greater in patients with WHO Grade 2 meningioma (p < 0.002) than in patients with WHO Grade 1 or unknown histologic features. Patients treated for recurrent meningioma showed a trend toward decreased progression-free survival compared with patients treated with primary therapy, after biopsy, or after subtotal resection (p < 0.06). Patients with a tumor volume >60 cm{sup 3} had a recurrence rate of 15.5% vs. 4.3% for those with a tumor volume of {<=}60 cm{sup 3} (p < 0.001). In 42.9% of the patients, preexisting neurologic deficits improved. Worsening of preexisting neurologic symptoms occurred in 8.2%. Eight patients developed new clinical symptoms, such as reduced vision, trigeminal neuralgia, and intermittent tinnitus located at the side of the irradiated meningioma after FSRT. Conclusion: These data have demonstrated that FSRT is an effective and safe treatment modality for local control of meningioma with a low risk of significant late toxicity. We identified the tumor volume, indication for FSRT, and histologic features of the meningioma as statistically significant prognostic factors.}
doi = {10.1016/j.ijrobp.2004.07.669}
journal = {International Journal of Radiation Oncology, Biology and Physics}
issue = {3}
volume = {61}
place = {United States}
year = {2005}
month = {Mar}
}