Long-term efficacy of fractionated radiotherapy for benign meningiomas

Multisession Radiosurgery for Sellar and Parasellar Benign Meningiomas

“…[27][28][29][30][31][32][33][34] The progression-free survival rate at 5 and 10 years ranges from 90.9% to 100% and from 82.0% to 87.7%, respectively. The reported toxicity rate is generally low; in particular, the rate of new or worsened deficits of cranial nerves ranges from 0.5% to 9.6%.…”

“…30 The statistical analysis failed to demonstrate a correlation between treatment volumes and visual outcome. This could be an expression of the fact that treatment volumes, optic pathway compression, and optic neuropathy are not necessarily related.…”

Fractionated radiotherapy and radiosurgery of intracranial meningiomas

“…Optic neuropathy and retinopathy following FRT are rare using doses ≤ 54 Gy [70]. Pituitary hormone insufficiency, seizures, hearing and other cranial nerve deficits and neurocognitive deficiencies have occasionally been reported [23,64,71]. Debus et al [64] reported late grade 3 radiation morbidity symptoms, such as reduced vision, visual-field defect and trigeminal neuropathy, in 2.1% patients, whereas Milker-Zabel et al [20] did not report any significant acute or late grade 3 symptoms.…”

“…Santacroce et al [28] reported a 5-year and 10-year PFS of 95.2 and 88.6% respectively, in more than 4500 patients treated with gamma knife SRS, with very low morbidity. As regards FRT, at 5 and 10 years respectively, 93-95% and 86-88% of patients with grade I meningioma are free of progression [16,23]. Morbidity may be higher but FRT is usually used to treat larger meningiomas and/or involving critical structures.…”

“…large growing tumor causing significant symptoms, or special locations, such as involvement of critical structures such as the cavernous sinus or the optic nerve, or close contact with critical structures, external beam fractionated radiotherapy (FRT) remains an alternative. Numerous studies have reported that FRT decreases tumor recurrence and improves survival, after partial tumor resection or as primary treatment for unresectable meningiomas, such as optic nerve sheath and cavernous sinus meningioma (Table 1) [16][17][18][19][20][21][22][23][24]. However, most series report uni-or multicenter retrospective experience.…”