Clinical outcome after high-precision radiotherapy for skull base meningiomas: Pooled data from three large German centers for radiation oncology

Combs, Stephanie E.; Farzin, Mostafa; Boehmer, Julia; Oehlke, Oliver; Molls, M.; Debus, Jürgen; Grosu, Anca‐Ligia

doi:10.1016/j.radonc.2018.03.006

Cited by 26 publications

(24 citation statements)

References 46 publications

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“…This was also true when comparing only patients with smaller volumes (< 47.0 cc). However, these differences in LC were not seen after multivariate analysis [36]. The authors concluded that SRS is an alternative to nFSRT.…”

Section: Discussionmentioning

confidence: 99%

Normofractionated stereotactic radiotherapy versus CyberKnife-based hypofractionation in skull base meningioma: a German and Italian pooled cohort analysis

et al. 2019

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BackgroundThis retrospective German and Italian multicenter analysis aimed to compare the role of normofractionated stereotactic radiotherapy (nFSRT) to CyberKnife-based hypofractionated stereotactic radiotherapy (CK-hFSRT) for skull base meningiomas.MethodsOverall, 341 patients across three centers were treated with either nFSRT or CK-hFSRT for skull base meningioma. Treatment planning was based on computed tomography (CT) and magnetic resonance imaging (MRI) following institutional guidelines. Most nFSRT patients received 33 × 1.8 Gy, and most CK-hFSRT patients received 5 × 5 Gy. The median follow-up time was 36 months (range: 1–232 months).ResultsIn the CK-hFSRT group, the 1-, 3-, and 10-year local control (LC) rates were 99.4, 96.8, and 80.3%, respectively. In the nFSRT group, the 1-, 3-, and 10-year LC rates were 100, 99, and 79.1%, respectively. There were no significant differences in LC rates between the nFSRT and CK-hFSRT groups (p = 0.56, hazard ratio = 0.76, 95% confidence interval, 0.3–1.9). In the CK-hFSRT group, only one case (0.49%) of severe toxicity (CTCAE 4.0 ≥ 3) was observed. In the nFSRT group, three cases (2.1%) of grade III toxicity were observed.ConclusionThis analysis of pooled data from three centers showed excellent LC and low side effect rates for patients treated with CK-hFSRT or nFSRT. The efficacy, safety, and convenience of a shortened treatment period provide a compelling case for the use of CK-hFSRT in patients with moderate size skull base meningioma and provided that OAR constraints are met.

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Section: Discussionmentioning

confidence: 99%

Normofractionated stereotactic radiotherapy versus CyberKnife-based hypofractionation in skull base meningioma: a German and Italian pooled cohort analysis

et al. 2019

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“…In recent years, more and more studies have been published that recommended radiotherapy after subtotal resected meningioma (9)(10)(11). However, few reports investigated the efficacy of postoperative radiotherapy for SOMs.…”

Section: Radiotherapymentioning

confidence: 99%

“…The additional effect of postoperative radiotherapy in meningioma is still a matter of debate. Stereotactic radiotherapy/radiosurgery has been shown to be effective in controlling the growth of meningioma (9,10), particularly for skull base meningioma (11). However, the literature on sphenoorbital meningioma is very poor regarding postoperative radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Progression-Free Survival, Prognostic Factors, and Surgical Outcome of Spheno-Orbital Meningiomas

et al. 2021

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ObjectiveSpheno-orbital meningiomas (SOM) are rare intracranial tumors that arise at the sphenoid wing. These tumors can invade important neurovascular structures making radical resection difficult, while residual tumors often lead to recurrence. The purpose of this study was to evaluate prognostic factors influencing the recurrence and progression-free survival (PFS) rates of spheno-orbital meningiomas, with a particular focus on the role of surgery and postoperative radiotherapy.MethodsBetween 2000 and March 2020, 65 cases of spheno-orbital meningioma were included, of which 50 cases underwent surgical treatment alone, and 15 cases underwent resection and radiotherapy. A Kaplan-Meier analysis was performed to provide median point estimates and PFS rates; further, Cox regression analysis was used to identify significant factors associated with treatment.ResultsGross total resection significantly reduced the risk of recurrence (p-value = 0.0062). There was no significant benefit for progression-free survival after postoperative radiotherapy (p-value = 0.42). Additionally, spheno-orbital meningiomas with an invasion of the cavernous sinus and intraconal invasion showed significantly worse PFS compared to other locations (p-value = 0.017).ConclusionThe maximal safe resection remains the most important prognostic factor associated with lower recurrence rates and longer PFS in patients with spheno-orbital meningioma. The invasion of the cavernous sinus and intraconal invasion was an independent factor associated with worse PFS. Patients with postoperative high-precision radiotherapy did not show significantly better PFS due to the small number of patients.

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“…vestibular schwannoma or cavernous sinus meningioma [3,6]. Additionally, data available today for RT indications includes large and pooled series from experienced institutions underlining the growing role of RT in the interdisciplinary context [14].…”

Section: Introductionmentioning

confidence: 99%

ESTRO ACROP guideline for target volume delineation of skull base tumors

Combs¹,

Baumert

Bendszus

et al. 2021

Radiotherapy and Oncology

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Clinical outcome after high-precision radiotherapy for skull base meningiomas: Pooled data from three large German centers for radiation oncology

Cited by 26 publications

References 46 publications

Normofractionated stereotactic radiotherapy versus CyberKnife-based hypofractionation in skull base meningioma: a German and Italian pooled cohort analysis

Normofractionated stereotactic radiotherapy versus CyberKnife-based hypofractionation in skull base meningioma: a German and Italian pooled cohort analysis

Progression-Free Survival, Prognostic Factors, and Surgical Outcome of Spheno-Orbital Meningiomas

ESTRO ACROP guideline for target volume delineation of skull base tumors

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