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Gross Tumor and Intracranial Control Benefits with Fractionated Radiotherapy Compared with Stereotactic Radiosurgery for Patients with WHO Grade 2 Meningioma.
Gravbrot, Nicholas; Rock, Calvin B; Weil, Christopher R; Rock, Christian B; Burt, Lindsay M; DeCesaris, Cristina M; Jensen, Randy L; Shrieve, Dennis C; Cannon, Donald M.
Afiliación
  • Gravbrot N; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA. Electronic address: Nicholas.gravbrot@hci.utah.edu.
  • Rock CB; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
  • Weil CR; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA; Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
  • Rock CB; The Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA.
  • Burt LM; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
  • DeCesaris CM; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
  • Jensen RL; Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA.
  • Shrieve DC; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
  • Cannon DM; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
World Neurosurg ; 188: e259-e266, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38777319
ABSTRACT

OBJECTIVE:

Surgical resection is the mainstay of treatment for WHO grade 2 meningioma. Fractionated radiation therapy (RT) is frequently used after surgery, though many centers utilize stereotactic radiosurgery (SRS) for recurrence or progression. Herein, we report disease control outcomes from an institutional cohort with adjuvant fractionated RT versus salvage SRS.

METHODS:

We identified 32 patients from an institutional database with WHO grade 2 meningioma and residual/recurrent tumor treated with either SRS or fractionated RT. Patients were treated between 2007 and 2021 and had at least 1 year of follow-up. Kaplan-Meier estimators were used to determine gross tumor control (GTC) and intracranial control (IC). Univariate Cox proportional hazards models using biologically effective dose (BED) as a continuous parameter were used to assess for dose responses.

RESULTS:

With a median follow-up of 5.5 years, 13 patients (41%) received SRS to a recurrent or progressive nodule, 2 (6%) fractionated RT to a recurrent or progressive nodule, and 17 (53%) adjuvant fractionated RT following subtotal resection. Five-year GTC was higher with fractionated RT versus SRS (82% vs. 38%, P = 0.03). Five-year IC was also better with fractionated RT versus SRS (82% vs. 11%, P < 0.001). On univariate analysis, increasing BED10 was significantly associated with better GTC (P = 0.039); increasing BED3 was not (P = 0.82).

CONCLUSIONS:

In this patient cohort, GTC and IC were significantly higher in patients treated with adjuvant fractionated RT compared with salvage SRS. Increasing BED10 was associated with better GTC. Fractionated RT may provide a better therapeutic ratio than SRS for grade 2 meningiomas.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Radiocirugia / Fraccionamiento de la Dosis de Radiación / Neoplasias Meníngeas / Meningioma Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Radiocirugia / Fraccionamiento de la Dosis de Radiación / Neoplasias Meníngeas / Meningioma Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos