Brachytherapy as an Adjuvant for Recurrent Atypical and Malignant Meningiomas

Koch, Matthew J.; Agarwalla, Pankaj K.; Royce, Trevor J.; Shih, Helen A.; Oh, Kevin; Niemierko, A.; Mauceri, Thomas; Curry, William T.; Barker, Frederick G.; Loeffler, Jay S.

doi:10.1093/neuros/nyz115

Cited by 23 publications

(15 citation statements)

References 26 publications

(36 reference statements)

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“…The remaining 16 eligible studies included a total of 695 patients ( The quality of the summarized evidence is listed in Table 1. In all, there were 14 Level 4 studies, including 11 retrospective case reviews and three prospective case reviews, and two Level 3 case-control studies [3,5,[16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

“…The median dose in these studies was 100 Gy (range: 63 to 120 Gy) at a depth of 5 mm. Three studies used I-125 or Cs-131 seeds imbedded in the absorbable suture, and one study utilized a novel collagen tile carrier for seed placement [ 3 , 20 - 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of the four recurrent meningioma studies, all utilized intracavitary LDR techniques with I-125 or Cs-131 [3,[20][21][22]. Study characteristics are presented in Table 2 (Entries 10 -13).…”

Section: Meningioma Studiesmentioning

confidence: 99%

“…The median dose for the LDR studies was 81 Gy (range: 45 to 300 Gy) at a depth of 5 mm or 10 mm. Nine of the LDR studies utilized I-125 sources, two reported the use of both I-125 and Cs-131, and one used only Cs-131 [3,5,[16][17][18][19][20][21][22][23][24][25].…”

Section: Comparison Of Hdr Versus Ldr Techniquesmentioning

confidence: 99%

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Re-Irradiation Using Brachytherapy for Recurrent Intracranial Tumors: A Systematic Review and Meta-Analysis of the Literature

Choi¹,

Zabramski

2020

Cureus

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We aim to compare the efficacy and toxicity of re-irradiation using brachytherapy for patients with locally recurrent brain tumors after previous radiation therapy. Methods We performed a systematic review of the major biomedical databases from 2005 to 2020 for eligible studies where patients were treated with re-irradiation for recurrent same site tumors using brachytherapy. Tumor types included high-grade gliomas (HGG) (World Health Organization (WHO) Grades 3 and 4), meningiomas, and metastases. The outcomes of interest were median overall survival (OS) and progressionfree survival (PFS) after re-irradiation, the incidence of radiation necrosis (RN), and other relevant radiation-related adverse events (AE). We used a fixed-effect meta-analysis regression moderation model to compared results of interstitial versus intracavitary therapy, treatment with low-dose-rate (LDR) versus high-dose-rate (HDR) techniques, and outcomes by tumor type. Results The search resulted in a total of 194 articles. A total of 16 articles with 695 patients fulfilled the inclusion criteria and were selected for analysis. For high-grade glioma, meningioma, and brain metastasis the pooled meta-analysis showed mean symptomatic RN rates of 3.3% (standard error (SE) = 0.8%), 17.3% (SE = 5.0%), and 22.4% (SE = 7.0%), respectively, and mean rates of RN requiring surgical intervention of 3.0% (SE = 1.0%), 11.9% (SE = 5.3%), and 10.0% (SE = 7.3%), respectively.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Of the four recurrent meningioma studies, all utilized intracavitary LDR techniques with I-125 or Cs-131 [3,[20][21][22]. Study characteristics are presented in Table 2 (Entries 10 -13).…”

Section: Meningioma Studiesmentioning

confidence: 99%

Section: Comparison Of Hdr Versus Ldr Techniquesmentioning

confidence: 99%

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Re-Irradiation Using Brachytherapy for Recurrent Intracranial Tumors: A Systematic Review and Meta-Analysis of the Literature

Choi¹,

Zabramski

2020

Cureus

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“…Therefore, further development of the treatment strategy using radiotherapy is expected. For example, novel treatment strategies for recurrent SBMs, such as brachytherapy [33], may show treatment efficacy.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcome of First Recurrence Skull Base Meningiomas

Kuranari

Tamura

Tsuda

et al. 2019

JCM

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Skull base meningiomas (SBMs) are considered to be less aggressive and have a slower growth rate than non-SBMs. However, SBMs often develop local recurrences after surgical resection. Gross total removal is difficult because SBMs are deep-seated tumors and involve critical neurovascular structures. The treatment strategy for recurrent SBMs remains controversial. The present study aimed to evaluate the long-term clinical course and prognostic factors associated with shorter progression-free survival (PFS) of recurrent SBMs. This retrospective study included 85 recurrent SBMs from 65 patients who underwent surgery from January 2005 to September 2018. Overall survival (OS) and PFS were evaluated, and the associations among shorter PFS and age, sex, tumor size, lesions, World Health Organization (WHO) grading, removal rate, and time since prior surgery were analyzed. The median follow-up period for PFS was 68 months. The 2-, 5-, and 10-year PFS rates were 68.0%, 52.8%, and 22.7%, respectively. WHO grade II or III, multiple lesions, and tumor size were significantly associated with shorter PFS (p < 0.0001, p = 0.030, and p = 0.173, respectively). Although, radiotherapy did not improve PFS and OS for overall patients, PFS of the patients with subtotal and partial removal for WHO grade II SBMs was significantly improved by the radiotherapy. Multivariate analysis identified WHO grade II or III and multiple lesions as independent prognostic factors for shorter PFS (p < 0.0001 and p = 0.040, respectively). It is essential to estimate the risks associated with shorter PFS for patients with recurrent SBMs to aid in the development of appropriate postoperative strategies.

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Evolving concepts in meningioma management in the era of genomics

Hsieh,

Bi,

Ramesh

et al. 2024

Cancer

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Meningioma is the most common type of primary brain tumor. Surgical resection followed by surveillance is the first‐line treatment for the majority of symptomatic meningiomas; however, recent advances in molecular sequencing, DNA methylation, proteomics, and single‐cell sequencing provide insights into further characterizing this heterogeneous group of tumors with a wide range of prognoses. A subset of these tumors are highly aggressive and cause severe morbidity and mortality. Therefore, identifying those individuals with a poor prognosis and intervening are critical. This review aims to help readers interpret the molecular profiling of meningiomas to identify patients with worse prognoses and guide the management and strategy for surveillance.

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Brachytherapy as an Adjuvant for Recurrent Atypical and Malignant Meningiomas

Cited by 23 publications

References 26 publications

Re-Irradiation Using Brachytherapy for Recurrent Intracranial Tumors: A Systematic Review and Meta-Analysis of the Literature

Re-Irradiation Using Brachytherapy for Recurrent Intracranial Tumors: A Systematic Review and Meta-Analysis of the Literature

Long-Term Clinical Outcome of First Recurrence Skull Base Meningiomas

Evolving concepts in meningioma management in the era of genomics

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