Short Course Hypofractionated Radiotherapy for Frail or Elderly Patients With Meningioma.

Autor:	Sarhan N; Radiation Oncology, Princess Margaret Cancer Center, Toronto, CAN., Abduljabbar L; Radiation Oncology, King Fahad Specialist Hospital, Dammam, SAU.; Radiation Oncology, Princess Margaret Cancer Center, Toronto, CAN., Laperriere N; Radiation Oncology, Princess Margaret Cancer Center, Toronto, CAN., Shultz D; Radiation Oncology, Princess Margaret Cancer Center, Toronto, CAN., Asha M; Neurosurgery, Toronto Western Hospital, Toronto, CAN., Zadeh G; Neurosurgery, Toronto Western Hospital, Toronto, CAN., Millar BA; Radiation Oncology, Princess Margaret Cancer Center, Toronto, CAN., Tsang DS; Radiation Oncology, Princess Margaret Cancer Center, Toronto, CAN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2020 Jun 13; Vol. 12 (6), pp. e8604. Date of Electronic Publication: 2020 Jun 13.
DOI:	10.7759/cureus.8604
Abstrakt:	Purpose/Objective(s) The incidence of intracranial meningiomas increases with age. The standard of care treatment is complete surgical excision, followed by radiation therapy (RT) if indicated. However, six weeks of RT can be challenging for elderly or frail patients. The purpose of this study was to determine if short course RT is safe and effective in elderly patients with meningioma. Materials/Methods We performed a retrospective analysis of patients with meningioma treated with short course beam RT (5-15 fractions) at a single institution. Seventeen patients (94%) received 4005 cGy over 15 fractions and one patient (6%) received 2500 cGy over five fractions. Study endpoints were treatment toxicity (edema), progression-free (PFS) and overall survival (OS). Results Eighteen patients with histologically proven (n = 12) or radiologically presumed meningioma (n = 6, presumed grade I) were identified. Median age at treatment was 85 years (66-95 years). There were eight, eight and two patients with grade I, II and III tumours, respectively. Eight patients (44%) had radiologic edema prior to RT. Six (33%) required dexamethasone treatment during RT and the dose was increased during RT for two patients. Fourteen patients had reduced or no edema post-RT and 13 patients had stable or improving symptoms post-RT. Six patients had disease progression (five in-field, one out-of-field). Median PFS was 3.3 and 0.9 years for grade I and II/III tumours, respectively (p = 0.014). Median OS was 3.3 and 2.5 years for grade I and II/III tumours, respectively (p = 0.12). Conclusion Short course RT for elderly patients with meningioma is well-tolerated and can offer disease control for some patients, particularly those with grade I tumours. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2020, Sarhan et al.)
Databáze:	MEDLINE
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