Artikel
Stereotactic LINAC-radiosurgery for malignant meningiomas
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Veröffentlicht: | 20. Mai 2009 |
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Gliederung
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Objective: We evaluate the efficacy and side effects of stereotactic LINAC radiosurgery for malignant meningiomas.
Methods: From August 1990 to December 2003 16 patients with 28 malignant meningiomas grade II or III were treated by stereotactic LINAC Radiosurgery at our institution. The mean and median overall follow up were 58.2 months and 54.5 months, respectively (range 7.2–167.9 months). According to grading, 14 grade II meningiomas, group I (radiological follow up: mean 61.6 months; median 58.4 months; range 7.2–167.9 months) and 14 grade III meningiomas, group II (radiological follow up: mean 52.1 months; median 47.1 months; range 7.2–155.7 months) were included in this retrospective study. The median surface dose was 12Gy (range: 7–20Gy) with a median tumor volume of 4.75ml (range: 0.2–32.8 ml). In each patient the irradiation dose was chosen according to an in-house risk analysis (10Gy algorithm).
Results: Tumor shrinkage was seen in 9/28 (32.2%) meningiomas, and stable disease in 12/28 (42.9%). 7/28 (25%) showed a local tumor progression. The overall tumor control rate (TCR) was 81%, 73%, 73%, and 73% after 3, 5, 10, and 13 years. With respect to grading the corresponding TCR was 85% for grade II and 77%, 60%, 60%, and 60% for grade III meningiomas. The overall progression free survival rate (PFS) was 75%, 67%, 57%, and 0% after 3, 5, 10, and 15 years. With respect to grading the corresponding PFS was 88% after 3 years and 73% after 5, 10, and 15 years for grade II meningiomas and 57%, 57%, 43%, and 0% after 3, 5, 10, and 15 years for grade III meningiomas. The clinical database included 16 patients with 28 treated meningiomas. Nine patients had grade II meningiomas and 7 patients had grade III meningiomas. Clinical improvement was seen in 4 patients (4/16; 25%), no change in 9 (9/16; 68.8%) and deterioration in 1 (1/16; 6.2%).
Conclusions: Our results show the efficacy and safety of LINAC- radiosurgery for malignant meningiomas with a relatively high local tumor control and low morbidity.