Cargando…

Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy

Introduction: Hypofractionated stereotactic radiotherapy (hSRT) has emerged as an alternative to single-fraction stereotactic radiosurgery (SRS) and conventionally fractionated radiotherapy for the treatment of intracranial meningiomas (ICMs). However, there is a need for data showing long-term effi...

Descripción completa

Detalles Bibliográficos
Autores principales: Nguyen, Eric K., Pond, Gregory R., Greenspoon, Jeffrey N., Whitton, Anthony C., Hann, Crystal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482200/
https://www.ncbi.nlm.nih.gov/pubmed/34590613
http://dx.doi.org/10.3390/curroncol28050314
_version_ 1784576850818760704
author Nguyen, Eric K.
Pond, Gregory R.
Greenspoon, Jeffrey N.
Whitton, Anthony C.
Hann, Crystal
author_facet Nguyen, Eric K.
Pond, Gregory R.
Greenspoon, Jeffrey N.
Whitton, Anthony C.
Hann, Crystal
author_sort Nguyen, Eric K.
collection PubMed
description Introduction: Hypofractionated stereotactic radiotherapy (hSRT) has emerged as an alternative to single-fraction stereotactic radiosurgery (SRS) and conventionally fractionated radiotherapy for the treatment of intracranial meningiomas (ICMs). However, there is a need for data showing long-term efficacy and complication rates, particularly for larger tumors in sensitive locations. Methods: A retrospective review was conducted on adult patients with ICMs seen at a tertiary care center. Eligible patients were treated with the CyberKnife platform and had a planned treatment course of 3–5 fractions from 2011–2020. The local control was assessed based on radiographic stability and the late toxicity/radionecrosis rates were recorded. Radiographic progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Results: In total, 62 patients (age 26–87) with 67 treated tumors were included in this study with a median follow-up of 64.7 months. RT was delivered as the primary treatment in 62.7% of cases and for recurrence in 37.3%. The most common tumor locations were the convexity of the brain and the base of the skull. The tumor sizes ranged from 0.1–51.8 cc and the median planning target volume was 4.9 cc. The most common treatment schedule was 18 Gy in 3 fractions. The five-year PFS and OS were 85.2% and 91.0%, respectively. The late grade III/IV toxicity rate was 3.2% and the radionecrosis rate was 4.8%. Conclusions: Based on our data, hSRT remains an effective modality to treat low-grade ICMs with acceptable long-term toxicity and radionecrosis rates. hSRT should be offered to patients who are not ideal candidates for SRS while preserving the benefits of hypofractionation.
format Online
Article
Text
id pubmed-8482200
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-84822002021-10-01 Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy Nguyen, Eric K. Pond, Gregory R. Greenspoon, Jeffrey N. Whitton, Anthony C. Hann, Crystal Curr Oncol Article Introduction: Hypofractionated stereotactic radiotherapy (hSRT) has emerged as an alternative to single-fraction stereotactic radiosurgery (SRS) and conventionally fractionated radiotherapy for the treatment of intracranial meningiomas (ICMs). However, there is a need for data showing long-term efficacy and complication rates, particularly for larger tumors in sensitive locations. Methods: A retrospective review was conducted on adult patients with ICMs seen at a tertiary care center. Eligible patients were treated with the CyberKnife platform and had a planned treatment course of 3–5 fractions from 2011–2020. The local control was assessed based on radiographic stability and the late toxicity/radionecrosis rates were recorded. Radiographic progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Results: In total, 62 patients (age 26–87) with 67 treated tumors were included in this study with a median follow-up of 64.7 months. RT was delivered as the primary treatment in 62.7% of cases and for recurrence in 37.3%. The most common tumor locations were the convexity of the brain and the base of the skull. The tumor sizes ranged from 0.1–51.8 cc and the median planning target volume was 4.9 cc. The most common treatment schedule was 18 Gy in 3 fractions. The five-year PFS and OS were 85.2% and 91.0%, respectively. The late grade III/IV toxicity rate was 3.2% and the radionecrosis rate was 4.8%. Conclusions: Based on our data, hSRT remains an effective modality to treat low-grade ICMs with acceptable long-term toxicity and radionecrosis rates. hSRT should be offered to patients who are not ideal candidates for SRS while preserving the benefits of hypofractionation. MDPI 2021-09-23 /pmc/articles/PMC8482200/ /pubmed/34590613 http://dx.doi.org/10.3390/curroncol28050314 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nguyen, Eric K.
Pond, Gregory R.
Greenspoon, Jeffrey N.
Whitton, Anthony C.
Hann, Crystal
Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy
title Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy
title_full Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy
title_fullStr Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy
title_full_unstemmed Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy
title_short Hypofractionated Stereotactic Radiotherapy for the Treatment of Benign Intracranial Meningiomas: Long-Term Safety and Efficacy
title_sort hypofractionated stereotactic radiotherapy for the treatment of benign intracranial meningiomas: long-term safety and efficacy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482200/
https://www.ncbi.nlm.nih.gov/pubmed/34590613
http://dx.doi.org/10.3390/curroncol28050314
work_keys_str_mv AT nguyenerick hypofractionatedstereotacticradiotherapyforthetreatmentofbenignintracranialmeningiomaslongtermsafetyandefficacy
AT pondgregoryr hypofractionatedstereotacticradiotherapyforthetreatmentofbenignintracranialmeningiomaslongtermsafetyandefficacy
AT greenspoonjeffreyn hypofractionatedstereotacticradiotherapyforthetreatmentofbenignintracranialmeningiomaslongtermsafetyandefficacy
AT whittonanthonyc hypofractionatedstereotacticradiotherapyforthetreatmentofbenignintracranialmeningiomaslongtermsafetyandefficacy
AT hanncrystal hypofractionatedstereotacticradiotherapyforthetreatmentofbenignintracranialmeningiomaslongtermsafetyandefficacy