Image-Guided Robotic Radiosurgery for Treatment of Recurrent Grade II and III Meningiomas. A Single-Center Study
| Autor: | Phuong Thuy Anh Nguyen, Güliz Acker, David Kaul, Peter Vajkoczy, Anne Kluge, Franziska Meinert, Alfredo Conti, Claudius Jelgersma, Markus Kufeld, Diana Pasemann, Carolin Senger, Mathias Lukas, Volker Budach, Franziska Loebel |
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| Přispěvatelé: | Acker G., Meinert F., Conti Alfredo, Kufeld M., Jelgersma C., Nguyen P., Kluge A., Lukas M., Loebel F., Pasemann D., Kaul D., Budach V., Vajkoczy P., Senger C. |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment CyberKnife Planning target volume Radiosurgery Single Center 03 medical and health sciences 0302 clinical medicine Cyberknife parasitic diseases Meningeal Neoplasms medicine Humans Risk factor Aged Retrospective Studies Aged 80 and over business.industry Age Factors Robotics Middle Aged Prognosis Progression-Free Survival Radiation therapy Treatment Outcome 030220 oncology & carcinogenesis Cohort Robotic radiosurgery Malignant meningioma Female Surgery Neurology (clinical) Radiology Neoplasm Grading Neoplasm Recurrence Local Meningioma business 030217 neurology & neurosurgery Radiotherapy Image-Guided |
| Zdroj: | World Neurosurgery. 131:e96-e107 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2019.07.058 |
| Popis: | Objective Stereotactic radiosurgery (SRS) has been increasingly applied for malignant meningiomas as an alternative to conventionally fractioned radiation therapy. We performed a retrospective analysis of an institutional patient cohort with malignant meningiomas treated by image-guided SRS. Methods All patients with atypical or anaplastic meningiomas who were treated by SRS using CyberKnife (CK) were identified. Local failure and regional and/or distant recurrences were evaluated together with toxicity and overall survival. Results We identified 127 treated lesions (105 atypical and 22 anaplastic) in 35 patients. The mean time interval between the last surgery and subsequent CK-SRS was 30.8 ± 24.5 months. Most lesions (83.5%) were treated using single-fraction CK-SRS. The median planning target volume of all 127 lesions was 1.71 cm3 (range, 0.06–22.5 cm3). The median follow-up period was 23 months (range, 2.1–60.3 months). The estimated local control rates were 97%, 77%, and 67% at 12, 36, and 60 months, respectively, in atypical meningiomas and 66% each at 12 and 24 months in anaplastic meningiomas. The regional progression-free survival was 93%, 73%, and 59% at 12, 36, and 60 months, respectively, in atypical lesions and 93% and 46% at 12 and 24 months in anaplastic lesions. The estimated distant tumor progression-free interval in atypical lesions was 80%, 44%, and 44% at 12, 36, and 60 months, respectively, and 49% and 24% at 12 and 24 months, respectively, in anaplastic lesions. Age was identified as a risk factor for local failure. Conclusions Although the real boundaries of efficacy of SRS have to be further evaluated in a prospective trial, it seems that aggressive treatment by high-dose single or multisession SRS of recurring malignant meningiomas provides satisfactory local control rates. |
| Databáze: | OpenAIRE |
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