Patterns of failure after radiosurgery for WHO grade 1 or imaging defined meningiomas: Long-term outcomes and implications for management.

Autor: Rock CB; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA. Electronic address: calvin.rock@hci.utah.edu., Weil CR; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Rock CB; Joe R and Teresa Lozano Long School of Medicine, University of Texas, San Antonio, TX, USA., Gravbrot N; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Burt LM; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., DeCesaris C; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Menacho ST; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA., Jensen RL; Department of Neurosurgery, University of Utah, Salt Lake City, UT, USA., Shrieve DC; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Cannon DM; Department of Radiation Oncology Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2024 Feb; Vol. 120, pp. 175-180. Date of Electronic Publication: 2024 Jan 22.
DOI: 10.1016/j.jocn.2024.01.012
Abstrakt: Background: We analyzed long-term control and patterns of failure in patients with World Health Organization Grade 1 meningiomas treated with definitive or postoperative stereotactic radiosurgery at the authors' affiliated institution.
Methods: 96 patients were treated between 2004 and 2019 with definitive (n = 57) or postoperative (n = 39) stereotactic radiosurgery. Of the postoperative patients, 17 were treated adjuvantly following subtotal resection and 22 were treated as salvage at time of progression. Patients were treated to the gross tumor alone without margin or coverage of the dural tail to a median dose of 15 Gy. Median follow up was 7.4 years (inter-quartile range 4.8-11.3). Local control, marginal control, regional control, and progression-free survival were analyzed.
Results: Local control at 5 and 10 years was 97 % and 95 %. PFS at 5 and 10 years was 94 % and 90 % with no failures reported after 6 years. Definitive and postoperative local control were similar at 5 (95 % [82-99 %] vs. 100 %) and 10 years (92 % [82-99 %] vs. 100 %). Patients treated with postoperative SRS did not have an increased marginal failure rate (p = 0.83) and only 2/39 (5 %) experienced recurrence elsewhere in the cavity.
Conclusions: Stereotactic radiosurgery targeting the gross tumor alone provides excellent local control and progression free survival in patients treated definitively and postoperatively. As in the definitive setting, patients treated postoperatively can be treated to gross tumor alone without need for additional margin or dural tail coverage.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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