Stereotactic radiosurgery for treatment of radiation-induced meningiomas: a multiinstitutional study
| Autor: | Jaromir Hanuska, Love Buch, Jennifer L. Peterson, Jason P. Sheehan, Adomas Bunevicius, Akiyoshi Ogino, Anne Marie Langlois, Ronald E Warnick, Hideyuki Kano, James McInerney, Gabriel Zada, Anissa Saylany, L. Dade Lunsford, Catherine Caldwell, Huai-Che Yang, Mohand Suleiman, Roberto Martínez Álvarez, Cheng-Chia Lee, Christine Mau, Daniel M. Trifiletti, Brad E. Zacharia, Samir Patel, Leonard Tuanquin, David Mathieu, Ben A. Strickland, John Y K Lee, Eric L. Chang, Nuria Martinez Moreno, Roman Liscak |
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| Rok vydání: | 2021 |
| Předmět: |
Medulloblastoma
medicine.medical_specialty business.industry medicine.medical_treatment Planning target volume Radiation induced General Medicine medicine.disease Cranial radiation Radiosurgery 03 medical and health sciences Safety profile 0302 clinical medicine Cranial Irradiation 030220 oncology & carcinogenesis parasitic diseases Medicine Progression-free survival Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurosurgery. 135:862-870 |
| ISSN: | 1933-0693 0022-3085 |
| Popis: | OBJECTIVE Radiation-induced meningiomas (RIMs) are associated with aggressive clinical behavior. Stereotactic radiosurgery (SRS) is sometimes considered for selected RIMs. The authors investigated the effectiveness and safety of SRS for the management of RIMs. METHODS From 12 institutions participating in the International Radiosurgery Research Foundation, the authors pooled patients who had prior cranial irradiation and were subsequently clinically diagnosed with WHO grade I meningiomas that were managed with SRS. RESULTS Fifty-two patients underwent 60 SRS procedures for histologically confirmed or radiologically suspected WHO grade I RIMs. The median ages at initial cranial radiation therapy and SRS for RIM were 5.5 years and 39 years, respectively. The most common reasons for cranial radiation therapy were leukemia (21%) and medulloblastoma (17%). There were 39 multiple RIMs (35%), the mean target volume was 8.61 ± 7.80 cm3, and the median prescription dose was 14 Gy. The median imaging follow-up duration was 48 months (range 4–195 months). RIM progressed in 9 patients (17%) at a median duration of 30 months (range 3–45 months) after SRS. Progression-free survival at 5 years post-SRS was 83%. Treatment volume ≥ 5 cm3 predicted progression (HR 8.226, 95% CI 1.028–65.857, p = 0.047). Seven patients (14%) developed new neurological symptoms or experienced SRS-related complications or T2 signal change from 1 to 72 months after SRS. CONCLUSIONS SRS is associated with durable local control of RIMs in the majority of patients and has an acceptable safety profile. SRS can be considered for patients and tumors that are deemed suboptimal, poor surgical candidates, and those whose tumor again progresses after removal. |
| Databáze: | OpenAIRE |
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