Stereotactic LINAC radiosurgery for the treatment of typical intracranial meningiomas. Efficacy and safety after a follow-up of over 12 years.

Abstract

PURPOSE:

The efficacy and safety of stereotactic radiosurgery (SRS) for treatment of intracranial meningiomas has been demonstrated in numerous studies with short- and intermediate-term follow-up. In this retrospective single-center study, we present long-term outcomes of SRS performed with a linear accelerator (LINAC) for typical intracranial meningiomas.

PATIENTS AND METHODS:

Between August 1990 and December 2007, 148 patients with 168 typical intracranial meningiomas were treated with stereotactic LINAC-SRS, either as primary treatment or after microsurgical resection. A median tumor surface dose of 12 Gy (range 7-20 Gy) and a median maximum dose of 24.1 Gy (range 11.3-58.6 Gy) was applied. The median target volume was 4.7 ml (range 0.2-32.8 ml, SD ± 4.8 ml).

RESULTS:

Overall mean radiological follow-up was 12.6 years. Tumor shrinkage was seen in 75 (44.6 %) and stable disease in 85 (50.6 %) cases. Eight of 168 meningiomas (4.8 %) showed local tumor progression. The tumor control rate (TCR) after 5, 10, and 15 years was 93.6 % at each time point, and the progression-free survival (PSF) rates were 92, 89, and 89 %, respectively. The neurological symptoms existing prior to LINAC-SRS improved in 77 patients (59.7 %), remained unchanged in 42 (32.6 %), and deteriorated in 10 (7.8 %) patients.

CONCLUSION:

Our study emphasizes the efficacy of LINAC-SRS for de novo, residual and recurrent typical intracranial meningiomas. A high long-term local TCR with a low morbidity rate could be achieved. LINAC-SRS should thus be considered as a primary treatment option, as one arm of a combined treatment approach for incompletely resected meningiomas, or as a salvage therapy for recurrences.

• Authors: Mustafa El-Khatib, Faycal El Majdoub, Stefan Hunsche, Mauritius Hoevels, Martin Kocher, Volker Sturm, Mohammad Maarouf
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 191 Issue 12 Pg. 921-7 (Dec 2015) ISSN: 1439-099X [Electronic] Germany
• PMID: 26253788 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Follow-Up Studies
• Germany
• Humans
• Male
• Meningeal Neoplasms (diagnosis, surgery)
• Meningioma (diagnosis, surgery)
• Microsurgery
• Middle Aged
• Neoplasm Recurrence, Local (diagnosis, surgery)
• Neoplasm, Residual (diagnosis, surgery)
• Neurologic Examination
• Postoperative Complications (diagnosis)
• Radiosurgery
• Reoperation
• Treatment Outcome
• Young Adult