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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Earlier and sustained response to the incidental use of cardiovascular drugs in patients with low-grade meningiomas treated with radiosurgery (SRS) or stereotactic radiotherapy (SRT)

Meeting Abstract

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  • Bogdan Pintea - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • Thomas M. Kinfe - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn
  • B. Baumert - Abteilung für Radiochirurgie und Stereotaktische Radiotherapie, MediClin Robert Janker Klinik, Bonn
  • Jan P. Boström - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn; Abteilung für Radiochirurgie und Stereotaktische Radiotherapie, MediClin Robert Janker Klinik, Bonn

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 051

doi: 10.3205/14dgnc447, urn:nbn:de:0183-14dgnc4474

Published: May 13, 2014

© 2014 Pintea et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Novel clinical studies yielded beneficial clinical outcome in patients with malignant CNS tumors treated with radiotherapy (RT) and cardiovascular drugs. The goal of this study was to determine the combined impact of RT with the incidental use of cardiovascular drugs in patients with meningiomas.

Method: We prospectively reviewed 64 patients with 70 intracranial meningiomas (WHO I/II) with sustained radiotherapy/cardiovascular drug therapy. The tumor volume was defined in 3 groups (progress, idem, regression) within defined follow-up intervals of 3, 12 and 24 months based on volumetric MR-imaging and clinical examination.

Results: Out of the 64 patients. 27 used beta blocker medication, 32 used antihypertensives regularly regularly and 9 used sympathomimetics. Of the 70 treated meningiomas, 49 had SRT and 21 SRS. At the one year control stage, there was a significantly better outcome for patients with antihypertensive use (p=0.008) and SRS (p=0.054), for the first group this difference remains significant even in the multivariate regression analysis. 2 years after RT, patients using beta blockers had a significantly better response to RT (p=0.038). The Kaplan Meier analysis of the data reveals a marginally significant faster response when using beta blockers compared to the control group (p(one tailed)=0.059).

Conclusions: In contrast to an earlier stage (at 3 months follow-up) cardiovascular drugs in terms of antihypertensive medication revealed a significantly earlier regression of tumor volume compared to non-medicalyl treated patients after one year. After 24 months follow-up this holds true only in the beta blocker treated patients, leading to the conclusion that concomitant antihypertensive medication with systemic beta blockers may lead to an earlier and sustained response after RT in meningiomas by affecting the β-adrenergic pathways.