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

Stefanie Milker-Zabel, Angelika Zabel, Daniela Schulz-Ertner, Wolfgang Schlegel, Michael Wannenmacher, Jürgen Debus

Research output: Contribution to journalArticle

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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 cm3 (range, 1.0-412.6 cm3). 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 cm3 had a recurrence rate of 15.5% vs. 4.3% for those with a tumor volume of ≤60 cm3 (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. © 2005 Elsevier Inc.

Original languageEnglish (US)
Pages (from-to)809-816
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume61
Issue number3
DOIs
StatePublished - Mar 1 2005

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Meningioma
Radiotherapy
Tumors
Health
Neoplasms
Biopsy
Magnetic resonance imaging
Tumor Burden
Neurologic Manifestations
Toxicity
Low Vision
Trigeminal Neuralgia
Tinnitus
Disease-Free Survival
Recurrence

Keywords

  • Fractionated stereotactic radiotherapy
  • Intracranial meningioma
  • Local control
  • Prognostic factors

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma : Long-term experience and prognostic factors. / Milker-Zabel, Stefanie; Zabel, Angelika; Schulz-Ertner, Daniela; Schlegel, Wolfgang; Wannenmacher, Michael; Debus, Jürgen.

In: International Journal of Radiation Oncology Biology Physics, Vol. 61, No. 3, 01.03.2005, p. 809-816.

Research output: Contribution to journalArticle

Milker-Zabel, Stefanie; Zabel, Angelika; Schulz-Ertner, Daniela; Schlegel, Wolfgang; Wannenmacher, Michael; Debus, Jürgen / Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma : Long-term experience and prognostic factors.

In: International Journal of Radiation Oncology Biology Physics, Vol. 61, No. 3, 01.03.2005, p. 809-816.

Research output: Contribution to journalArticle

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