Stereotactic radiosurgery of World Health Organization grade II and III intracranial meningiomas: Treatment results on the basis of a 22-year experience

Bruce E. Pollock, Scott L. Stafford, Michael J. Link, Yolanda I. Garces, Robert L. Foote

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

Background: 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. Methods: 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 cm 3; 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). Results: 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 cm 3 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)1048-1054
Number of pages7
JournalCancer
Volume118
Issue number4
DOIs
StatePublished - Feb 15 2012

Keywords

  • brain tumor
  • external beam radiation therapy
  • meningioma
  • stereotactic radiosurgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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