Artikel
Stereotactic radiosurgery for treating meningiomas WHO grade I eligible for complete resection
Stereotaktische Radiochirurgie für die Behandlung von komplett resektablen Meningeomen WHO I
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Autoren
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Maximilian I. Ruge
- University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Köln, Deutschland
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Juman Tutunji
- University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Köln, Deutschland
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Daniel Rueß
- University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Köln, Deutschland
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Eren Celik
- University Hospital Cologne, University of Cologne, Department of Radiation Oncology, Köln, Deutschland
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Christian Baues
- University Hospital Cologne, University of Cologne, Department of Radiation Oncology, Köln, Deutschland
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Harald Treuer
- University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Köln, Deutschland
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Martin Kocher
- University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Centre of Neurosurgery, Köln, Deutschland
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Stefan Grau
- University Hospital Cologne, University of Cologne, Department of General Neurosurgery, Centre for Neurosurgery, Köln, Deutschland
| Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: For meningiomas, complete resection is recommended as first-line treatment following the EANO guidelines while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient’s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases.
Methods: In this retrospective single-centre analysis we included patients receiving single fraction LINAC-based SRS for potentially resectable intracranial meningiomas. Treatment related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan-Meier method.
Results: We analyzed 188 patients with 218 meningiomas. The median radiological and clinical follow-up periods were 51.4 (6.2-289.6) and 55.8 (6.2-300.9) months, respectively. The median tumor volume was 4.2ml (0.1-22), and the mean marginal radiation dose was 13.0±3.1Gy, with reference to the 80.0±11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-,5-,10-and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (<6 months after SRS) occurred in 11.2% (CTCEA grade 1-2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1-2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p<0.03) and correlated with the treatment volume (p<0.02).
Conclusion: SRS is also a highly effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.
