Stephanie E Combs1, Mostafa Farzin2, Julia Boehmer3, Oliver Oehlke4, Michael Molls2, Jürgen Debus5, Anca-Ligia Grosu4. 1. Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Germany; Institute of Innovative Radiotherapy (iRT), Helmholtz Zentrum München, Germany; Deutsches Konsortium für Translationale Krebsforschung (dktk), Partner Site Munich, Germany. Electronic address: Stephanie.combs@tum.de. 2. Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Germany. 3. Department of Radiation Oncology, University Hospital of Freiburg, Germany. 4. Department of Radiation Oncology, University Hospital of Freiburg, Germany; Deutsches Konsortium für Translationale Krebsforschung (dktk), Partner Site Freiburg, Germany. 5. Department of Radiation Oncology, University Hospital of Heidelberg, Germany; Deutsches Konsortium für Translationale Krebsforschung (dktk), Partner Site Heidelberg, Germany.
Abstract
PURPOSE: To evaluate outcome in patients with base of skull meningiomas treated with modern high precision radiation therapy (RT) techniques. PATIENTS AND METHODS: 927 patients from three centers were treated with either radiosurgery or fractionated high-precision RT for meningiomas. Treatment planning was based on CT and MRI following institutional guidelines. For radiosurgery, a median dose of 13 Gy was applied, for fractionated treatments, a median dose of 54 Gy in 1.8 Gy single fractions was prescribed. Follow-up included a clinical examination as well as contrast-enhanced imaging. All patients were followed up prospectively after radiotherapy in the three departments within a strict follow-up regimen. The median follow-up time was 81 months (range 1-348 months). RESULTS: Median local control was 79 months (range 1-348 months). Local control (LC) was 98% at 1 year, 94% at 3 years, 92% at 5 years and 86% at 10 years. There was no difference between radiosurgery and fractionated RT. We analyzed the influence of higher doses on LC and could show that dose did not impact LC. Moreover, there was no difference between 54 Gy and 57.6 Gy in the fractionated group. Side effects were below 5% in both groups without any severe treatment-related complications. DISCUSSION: Based on the pooled data analysis this manuscript provides a large series of meningiomas of the skull base treated with modern high precision RT demonstrating excellent local control and low rates of side effects. Such data support the recommendation of RT for skull base meningiomas in the interdisciplinary tumor board discussions. The strong role of RT must influence treatment recommendations keeping in mind the individual risk-benefit profile of treatment alternatives.
PURPOSE: To evaluate outcome in patients with base of skull meningiomas treated with modern high precision radiation therapy (RT) techniques. PATIENTS AND METHODS: 927 patients from three centers were treated with either radiosurgery or fractionated high-precision RT for meningiomas. Treatment planning was based on CT and MRI following institutional guidelines. For radiosurgery, a median dose of 13 Gy was applied, for fractionated treatments, a median dose of 54 Gy in 1.8 Gy single fractions was prescribed. Follow-up included a clinical examination as well as contrast-enhanced imaging. All patients were followed up prospectively after radiotherapy in the three departments within a strict follow-up regimen. The median follow-up time was 81 months (range 1-348 months). RESULTS: Median local control was 79 months (range 1-348 months). Local control (LC) was 98% at 1 year, 94% at 3 years, 92% at 5 years and 86% at 10 years. There was no difference between radiosurgery and fractionated RT. We analyzed the influence of higher doses on LC and could show that dose did not impact LC. Moreover, there was no difference between 54 Gy and 57.6 Gy in the fractionated group. Side effects were below 5% in both groups without any severe treatment-related complications. DISCUSSION: Based on the pooled data analysis this manuscript provides a large series of meningiomas of the skull base treated with modern high precision RT demonstrating excellent local control and low rates of side effects. Such data support the recommendation of RT for skull base meningiomas in the interdisciplinary tumor board discussions. The strong role of RT must influence treatment recommendations keeping in mind the individual risk-benefit profile of treatment alternatives.
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