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Radiation Oncology
Published in: Radiation Oncology 1/2011

Open Access 01-12-2011 | Research

Fractionated stereotactic conformal radiotherapy for large benign skull base meningiomas

Authors: Giuseppe Minniti, Enrico Clarke, Luigi Cavallo, Mattia Falchetto Osti, Vincenzo Esposito, Gianpaolo Cantore, Paolo Cappabianca, Riccardo Maurizi Enrici

Published in: Radiation Oncology | Issue 1/2011

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Abstract

Purpose

to assess the safety and efficacy of fractionated stereotactic radiotherapy (FSRT) for large skull base meningiomas.

Methods and Materials

Fifty-two patients with large skull base meningiomas aged 34-74 years (median age 56 years) were treated with FSRT between June 2004 and August 2009. All patients received FSRT for residual or progressive meningiomas more than 4 centimeters in greatest dimension. The median GTV was 35.4 cm3 (range 24.1-94.9 cm3), and the median PTV was 47.6 cm3 (range 33.5-142.7 cm3). Treatment volumes were achieved with 5-8 noncoplanar beams shaped using a micromultileaf collimator (MLC). Treatment was delivered in 30 daily fractions over 6 weeks to a total dose of 50 Gy using 6 MV photons. Outcome was assessed prospectively.

Results

At a median follow-up of 42 months (range 9-72 months) the 3-year and 5-year progression-free survival (PFS) rates were 96% and 93%, respectively, and survival was 100%. Three patients required further debulking surgery for progressive disease. Hypopituitarism was the most commonly reported late complication, with a new hormone pituitary deficit occurring in 10 (19%) of patients. Clinically significant late neurological toxicity was observed in 3 (5.5%) patients consisting of worsening of pre-existing cranial deficits.

Conclusion

FSRT as a high-precision technique of localized RT is suitable for the treatment of large skull base meningiomas. The local control is comparable to that reported following conventional external beam RT. Longer follow-up is required to assess long term efficacy and toxicity, particularly in terms of potential reduction of treatment-related late toxicity.
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Metadata
Title
Fractionated stereotactic conformal radiotherapy for large benign skull base meningiomas
Authors
Giuseppe Minniti
Enrico Clarke
Luigi Cavallo
Mattia Falchetto Osti
Vincenzo Esposito
Gianpaolo Cantore
Paolo Cappabianca
Riccardo Maurizi Enrici
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-6-36

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