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Stereotactic radiosurgery of World Health Organization grade II and III intracranial meningiomas
Treatment results on the basis of a 22-year experience
Version of Record online: 19 JUL 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 4, pages 1048–1054, 15 February 2012
How to Cite
Pollock, B. E., Stafford, S. L., Link, M. J., Garces, Y. I. and Foote, R. L. (2012), Stereotactic radiosurgery of World Health Organization grade II and III intracranial meningiomas. Cancer, 118: 1048–1054. doi: 10.1002/cncr.26362
- Issue online: 3 FEB 2012
- Version of Record online: 19 JUL 2011
- Manuscript Accepted: 25 MAY 2011
- Manuscript Revised: 29 APR 2011
- Manuscript Received: 23 FEB 2011
- brain tumor;
- stereotactic radiosurgery;
- external beam radiation therapy
A study was undertaken to define the variables associated with tumor control and survival after single-session stereotactic radiosurgery (SRS) for patients with atypical and malignant intracranial meningiomas.
Fifty patients with World Health Organization (WHO) grade II (n = 37) or grade III (n = 13) meningiomas underwent SRS from 1990 to 2008. Most tumors were located in the falx/parasagittal region or cerebral convexities (n = 35, 70%). Twenty patients (40%) had progressing tumors despite prior external beam radiation therapy (EBRT) (median dose, 54.0 grays [Gy]). The median treatment volume was 14.6 cm3; the median tumor margin dose was 15.0 Gy. Seven patients (14%) received concurrent EBRT (median dose, 50.4 Gy). Follow-up (median, 38 months) was censored at last evaluation (n = 28) or death (n = 22).
Tumor grade correlated with disease-specific survival (DSS) (hazard ratio [HR], 3.4; P = .008), local tumor control (HR, 2.4; P = .02), and progression-free survival (PFS) (HR, 2.6; P = .02) on univariate analysis, but not on multivariate analysis. Multivariate analysis showed that having failed EBRT and tumor volume >14.6 cm3 were negative predictors of DSS and local control (HR, 3.0; P = .02 and HR, 4.4; P = .01; HR, 3.3; P = .001 and HR, 2.3; P = .02;, respectively). Having failed EBRT was a negative predictor of PFS (HR, 3.5; P = .002). Thirteen patients (26%) had radiation-related complications at a median of 6 months after radiosurgery.
Tumor progression despite prior EBRT and larger tumor volume are negative predictors of tumor control and survival for patients having SRS for WHO grade II and III intracranial meningiomas. Cancer 2012;. © 2011 American Cancer Society.