PURPOSE: To evaluate early treatment results and toxicity in patients with meningiomas treated with particle therapy. MATERIAL AND METHODS: Seventy patients with meningiomas were treated with protons (n = 38) or carbon ion radiotherapy (n = 26). Median age was 49 years. Median age at treatment was 55 years, 24 were male (34%), and 46 were female (66%). Histology was benign meningioma in 26 patients (37%), atypical in 23 patients (33%) and anaplastic in four patients (6%). In 17 patients (24%) with skull base meningiomas diagnosis was based on the typical appearance of a meningioma. For benign meningiomas, total doses of 52.2-57.6 GyE were applied with protons. For high-grade lesions, the boost volume was 18 GyE carbon ions, with a median dose of 50 GyE applied as highly conformal radiation therapy. Nineteen patients were treated as re-irradiation. Treatment planning with MRI and 68-Ga-DOTATOC-PET was evaluated. RESULTS: Very low rates of side effects developed, including headaches, nausea and dizziness. No severe treatment-related toxicity was observed. Local control for benign meningiomas was 100%. Five of 27 patients (19%) developed tumor recurrence during follow-up. Of these, four patients had been treated as re-irradiation for recurrent high-risk meningiomas. Actuarial local control after re-irradiation of high-risk meningiomas was therefore 67% at six and 12 months. In patients treated with primary radiotherapy, only one of 13 patients (8%) developed tumor recurrence 17 months after radiation therapy (photon and carbon ion boost). CONCLUSION: Continuous prospective follow-up and development of novel study concepts are required to fully exploit the long-term clinical data after particle therapy for meningiomas. To date, it may be concluded that when proton therapy is available, meningioma patients can be offered a treatment at least comparable to high-end photon therapy.
PURPOSE: To evaluate early treatment results and toxicity in patients with meningiomas treated with particle therapy. MATERIAL AND METHODS: Seventy patients with meningiomas were treated with protons (n = 38) or carbon ion radiotherapy (n = 26). Median age was 49 years. Median age at treatment was 55 years, 24 were male (34%), and 46 were female (66%). Histology was benign meningioma in 26 patients (37%), atypical in 23 patients (33%) and anaplastic in four patients (6%). In 17 patients (24%) with skull base meningiomas diagnosis was based on the typical appearance of a meningioma. For benign meningiomas, total doses of 52.2-57.6 GyE were applied with protons. For high-grade lesions, the boost volume was 18 GyE carbon ions, with a median dose of 50 GyE applied as highly conformal radiation therapy. Nineteen patients were treated as re-irradiation. Treatment planning with MRI and 68-Ga-DOTATOC-PET was evaluated. RESULTS: Very low rates of side effects developed, including headaches, nausea and dizziness. No severe treatment-related toxicity was observed. Local control for benign meningiomas was 100%. Five of 27 patients (19%) developed tumor recurrence during follow-up. Of these, four patients had been treated as re-irradiation for recurrent high-risk meningiomas. Actuarial local control after re-irradiation of high-risk meningiomas was therefore 67% at six and 12 months. In patients treated with primary radiotherapy, only one of 13 patients (8%) developed tumor recurrence 17 months after radiation therapy (photon and carbon ion boost). CONCLUSION: Continuous prospective follow-up and development of novel study concepts are required to fully exploit the long-term clinical data after particle therapy for meningiomas. To date, it may be concluded that when proton therapy is available, meningiomapatients can be offered a treatment at least comparable to high-end photon therapy.
Authors: Shadi A Esfahani; Stephanie Salcedo; Pedram Heidari; Onofrio A Catalano; Rachel Pauplis; Jacob Hesterman; James F Kronauge; Umar Mahmood Journal: Am J Nucl Med Mol Imaging Date: 2017-04-15
Authors: Kerstin A Kessel; Hanna Fischer; Markus Oechnser; Claus Zimmer; Bernhard Meyer; Stephanie E Combs Journal: Strahlenther Onkol Date: 2017-06-15 Impact factor: 3.621
Authors: Jacobo Cal-Gonzalez; Juan José Vaquero; Joaquín L Herraiz; Mailyn Pérez-Liva; María Luisa Soto-Montenegro; Santiago Peña-Zalbidea; Manuel Desco; José Manuel Udías Journal: Mol Imaging Biol Date: 2018-08 Impact factor: 3.488
Authors: Kerstin A Kessel; Wolfgang Weber; Igor Yakushev; Hanna Fischer; Theresa Voglhuber; Christian Diehl; Christoph Straube; Claus Zimmer; Benedikt Wiestler; Jens Gempt; Bernhard Meyer; Stephanie E Combs Journal: Eur J Nucl Med Mol Imaging Date: 2019-11-22 Impact factor: 9.236
Authors: María Luisa Soto-Montenegro; Santiago Peña-Zalbidea; Jose María Mateos-Pérez; Marta Oteo; Eduardo Romero; Miguel Ángel Morcillo; Manuel Desco Journal: PLoS One Date: 2014-11-04 Impact factor: 3.240