Health-related quality of life and clinical outcome after radiotherapy of patients with intracranial meningioma

Lisowski, Dominik; Trömel, Jannik; Lutyj, Paul; Lewitzki, V.; Hartrampf, Philipp E.; Polat, Bülent; Flentje, Michael; Tamihardja, Jörg

doi:10.1038/s41598-022-24192-8

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…There are some other papers assessing the QoL utilizing the QLQ-C30 and QLQ-BN20 questionnaires of intracranial meningioma patients treated with photon radiotherapy. One very recent publication sent out these questionnaires a median of 4.8 years after treatment to the patients with a good response rate of almost 60% [ 55 ]. The authors reported a lowered QoL and attributed it to the radiotherapy, but due to the retrospective nature of this investigation, no baseline values were available and thus no conclusive statement can be made.…”

Section: Discussionmentioning

confidence: 99%

Long Term Outcome and Quality of Life of Intracranial Meningioma Patients Treated with Pencil Beam Scanning Proton Therapy

Krcek

Leiser

García-Marqueta

et al. 2023

Cancers

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The aim of this study was to assess the clinical outcome, including QoL, of patients with intracranial meningiomas WHO grade 1–3 who were treated with Pencil Beam Scanning Proton Therapy (PBS PT) between 1997 and 2022. Two hundred patients (median age 50.4 years, 70% WHO grade 1) were analyzed. Acute and late side effects were classified according to CTCAE version 5.0. Time to event data were calculated. QoL was assessed descriptively by the EORTC-QLQ-C30 and BN20 questionnaires. With a median follow-up of 65 months (range: 3.8–260.8 months) the 5 year OS was 95.7% and 81.8% for WHO grade 1 and grade 2/3, respectively (p < 0.001). Twenty (10%) local failures were observed. Failures occurred significantly (p < 0.001) more frequent in WHO grade 2 or 3 meningioma (WHO grade 1: n = 7, WHO grade 2/3: n = 13), in patients with multiple meningiomas (p = 0.005), in male patients (p = 0.005), and when PT was initiated not as upfront therapy (p = 0.011). There were no high-grade toxicities in the majority (n = 176; 88%) of patients. QoL was assessed for 83 (41.5%) patients and for those patients PT did not impacted QoL negatively during the follow-up. In summary, we observed very few local recurrences of meningiomas after PBS PT, a stable QoL, and a low rate of high-grade toxicity.

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Section: Discussionmentioning

confidence: 99%

Long Term Outcome and Quality of Life of Intracranial Meningioma Patients Treated with Pencil Beam Scanning Proton Therapy

Krcek

Leiser

García-Marqueta

et al. 2023

Cancers

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“…Overall QoL in meningioma patients treated with radiotherapy may be lower than in those treated with surgery. 93 Specifically, in a study of 118 patients with NF2, patients whose treatment included any form of radiotherapy had a worse QoL than patients who did not, 94 although it is worth considering that the need for radiotherapy may have been due to a more aggressive disease course, also predictive of a worse QoL. 95 …”

Section: Clinical Management and Quality Of Life Outcomesmentioning

confidence: 99%

The clinical, genetic, and immune landscape of meningioma in patients with NF2-schwannomatosis

Gregory

Islim

Hannan

et al. 2023

Neuro-Oncology Advances

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NF2-schwannomatosis is the most common genetic predisposition syndrome associated with meningioma. Meningioma in NF2-schwannomatosis is a major source of morbidity and mortality. This is due to accumulative tumor burden in patients with synchronous schwannomas and ependymomas, sometimes including complex collision tumors. Balancing the impact of multiple interventions against the natural history of various index tumors, and the ongoing risk of de novo tumors over an individual’s lifetime makes decision-making complex. The management of any given individual meningioma is often different from a comparable sporadic tumor. There is typically a greater emphasis on conservative management and tolerating growth until a risk boundary is reached, whereby symptomatic deterioration or higher risk from anticipated future treatment is threatened. Management by high-volume multidisciplinary teams improves quality of life and life expectancy. Surgery remains the mainstay treatment for symptomatic and rapidly enlarging meningioma. Radiotherapy has an important role but carries a higher risk compared to its use in sporadic disease. Whilst bevacizumab is effective in NF2-associated schwannoma and cystic ependymoma, it has no value in the management of meningioma. In this review, we describe the natural history of the disease, underlying genetic, molecular, and immune microenvironment changes, current management paradigms, and potential therapeutic targets.

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“…This was attributed to the new onset of postoperative deficits including hemiparesis, swallowing difficulties, and hypoacusis. Intraoperative electrophysiological monitoring and adjuvant therapies such as radiation and systemic therapies may improve HRQoL outcomes in this population [20,61,62]. As a result, NTR may lead to better QOL outcomes than GTR for PCM patients.…”

Section: Posterior Skull Base Meningiomasmentioning

confidence: 99%

Health-Related Quality of Life Outcomes in Meningioma Patients Based upon Tumor Location and Treatment Modality: A Systematic Review and Meta-Analysis

San,

Rahman,

Sanmugananthan

et al. 2023

Cancers

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Patients with meningiomas may have reduced health-related quality of life (HRQoL) due to postoperative neurological deficits, cognitive dysfunction, and psychosocial burden. Although advances in surgery and radiotherapy have improved progression-free survival rates, there is limited evidence regarding treatment outcomes on HRQoL. This review examines HRQoL outcomes based on tumor location and treatment modality. A systematic search in PubMed yielded 28 studies with 3167 patients. The mean age was 54.27 years and most patients were female (70.8%). Approximately 78% of meningiomas were located in the skull base (10.8% anterior, 23.3% middle, and 39.7% posterior fossae). Treatment modalities included craniotomy (73.6%), radiotherapy (11.4%), and endoscopic endonasal approach (EEA) (4.0%). The Karnofsky Performance Scale (KPS) was the most commonly utilized HRQoL instrument (27%). Preoperative KPS scores > 80 were associated with increased occurrence of postoperative neurological deficits. A significant difference was found between pre- and post-operative KPS scores for anterior/middle skull base meningiomas (SBMs) in comparison to posterior (SBMs) when treated with craniotomy. Post-craniotomy SF-36 scores were lower for posterior SBMs in comparison to those in the anterior and middle fossae. Risk factors for poor neurological outcomes include a high preoperative KPS score and patients with posterior SBMs may experience a greater burden in HRQoL.

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Health-related quality of life and clinical outcome after radiotherapy of patients with intracranial meningioma

Cited by 7 publications

References 48 publications

Long Term Outcome and Quality of Life of Intracranial Meningioma Patients Treated with Pencil Beam Scanning Proton Therapy

Long Term Outcome and Quality of Life of Intracranial Meningioma Patients Treated with Pencil Beam Scanning Proton Therapy

The clinical, genetic, and immune landscape of meningioma in patients with NF2-schwannomatosis

Health-Related Quality of Life Outcomes in Meningioma Patients Based upon Tumor Location and Treatment Modality: A Systematic Review and Meta-Analysis

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