Maximilian I Ruge1, Juman Tutunji2, Daniel Rueß2, Eren Celik3, Christian Baues3, Harald Treuer2, Martin Kocher2, Stefan Grau4. 1. Department of Stereotactic and Functional Neurosurgery, Centre for Neurosurgery, Medical Faculty of the University of Cologne, Kerpener Strasse 62, LFI Gebäude Ebene 2, 50937, Cologne, Germany. Maximimilian.ruge@uk-koeln.de. 2. Department of Stereotactic and Functional Neurosurgery, Centre for Neurosurgery, Medical Faculty of the University of Cologne, Kerpener Strasse 62, LFI Gebäude Ebene 2, 50937, Cologne, Germany. 3. Department of Radiation Oncology and Cyberknife Centre, Medical Faculty of the University of Cologne, Cologne, Germany. 4. Department of General Neurosurgery, Centre for Neurosurgery, Medical Faculty of the University of Cologne, Cologne, Germany.
Abstract
BACKGROUND: For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient´s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases. METHODS: In this retrospective single-centre analysis we included patients receiving single fraction SRS either by modified LINAC or robotic guidance by Cyberknife for potentially resectable intracranial meningiomas. Treatment-related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan-Meier method. RESULTS: We analyzed 188 patients with 218 meningiomas. The median radiological, and clinical follow-up periods were 51.4 (6.2-289.6) and 55.8 (6.2-300.9) months. The median tumor volume was 4.2 ml (0.1-22), and the mean marginal radiation dose was 13.0 ± 3.1 Gy, with reference to the 80.0 ± 11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-, 5-, 10- and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (≤ 6 months after SRS) occurred in 11.2% (CTCEA grade 1-2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1-2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p < 0.03) and correlated with the treatment volume (p < 0.02). CONCLUSION: In this analysis SRS appears to be an effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.
BACKGROUND: For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient´s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases. METHODS: In this retrospective single-centre analysis we included patients receiving single fraction SRS either by modified LINAC or robotic guidance by Cyberknife for potentially resectable intracranial meningiomas. Treatment-related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan-Meier method. RESULTS: We analyzed 188 patients with 218 meningiomas. The median radiological, and clinical follow-up periods were 51.4 (6.2-289.6) and 55.8 (6.2-300.9) months. The median tumor volume was 4.2 ml (0.1-22), and the mean marginal radiation dose was 13.0 ± 3.1 Gy, with reference to the 80.0 ± 11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-, 5-, 10- and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (≤ 6 months after SRS) occurred in 11.2% (CTCEA grade 1-2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1-2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p < 0.03) and correlated with the treatment volume (p < 0.02). CONCLUSION: In this analysis SRS appears to be an effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.
Entities:
Keywords:
Adverse events; Local control; Meningioma WHO grade I; Regional control; Stereotactic radiosurgery (SRS)
Authors: Waseem Masalha; Dieter Henrik Heiland; Christine Steiert; Marie T Krüger; Daniel Schnell; Pamela Heiland; Marco Bissolo; Anca-L Grosu; Oliver Schnell; Jürgen Beck; Jürgen Grauvogel Journal: Cancers (Basel) Date: 2022-04-28 Impact factor: 6.575
Authors: Felix Ehret; Markus Kufeld; Christoph Fürweger; Alfred Haidenberger; Susanne Fichte; Ralph Lehrke; Carolin Senger; David Kaul; Martin Bleif; Gerd Becker; Daniel Rueß; Maximilian Ruge; Christian Schichor; Jörg-Christian Tonn; Alexander Muacevic Journal: Cancers (Basel) Date: 2022-01-11 Impact factor: 6.639