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Radiation Oncology

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Open Access 01-12-2014 | Research

Linac-based stereotactic radiotherapy and radiosurgery in patients with meningioma

Authors: David Kaul, Volker Budach, Reinhard Wurm, Arne Gruen, Lukas Graaf, Piet Habbel, Harun Badakhshi

Published in: Radiation Oncology | Issue 1/2014

Abstract

Background

It was our purpose to analyze long-term clinical outcome and to identify prognostic factors after Linac-based fractionated stereotactic radiotherapy (Linac-based FSRT) and stereotactic radiosurgery (SRS) in patients with intracranial meningiomas.

Materials and methods

Between 10/1995 and 03/2009, 297 patients with a median age of 59 years were treated with FSRT for intracranial meningioma. 50 patients had a Grade I meningioma, 20 patients had a Grade II meningioma, 12 patients suffered from a Grade III tumor, and in 215 cases no histology was obtained (Grade 0). Of the 297 patients, 144 underwent FSRT as their primary treatment and 158 underwent postoperative FSRT. 179 patients received normofractionated radiotherapy (nFSRT), 92 patients received hypofractionated FSRT (hFSRT) and 26 patients underwent SRS. Patients with nFSRT received a mean total dose of 57.31 ± 5.82 Gy, patients with hFSRT received a mean total dose of 37.6 ± 4.4 Gy and patients who underwent SRS received a mean total dose of 17.31 ± 2.58 Gy.

Results

Median follow-up was 35 months. Overall progression free survival (PFS) was 92.3% at 3 years, 87% at 5 years and 84.1% at 10 years. Patients with adjuvant radiotherapy showed significantly better PFS-rates than patients who had been treated with primary radiotherapy. There was no significant difference between PFS-rates of nFSRT, hFSRT and SRS patients. PFS-rates were independent of tumor size. Patients who had received nFSRT showed less acute toxicity than those who had received hFSRT. In the Grade 0/I group the rate of radiologic focal reactions was significantly lower than in the atypical/malignant histology group.

Conclusion

This large study showed that FSRT is an effective and safe treatment modality with high PFS-rates for intracranial meningioma. We identified “pathological grading” and and “prior surgery” as significant prognostic factors.

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Title: Linac-based stereotactic radiotherapy and radiosurgery in patients with meningioma
Authors: David Kaul
Volker Budach
Reinhard Wurm
Arne Gruen
Lukas Graaf
Piet Habbel
Harun Badakhshi
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-9-78

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Linac-based stereotactic radiotherapy and radiosurgery in patients with meningioma

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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