Significant Tumor Volume Reduction of Meningiomas After Stereotactic Radiotherapy

Henzel, Martin; Groß, Markus W.; Hamm, Klaus; Surber, Gunnar; Kleinert, Gabriele; Failing, Thomas; Strassmann, Gerd; Engenhart‐Cabillic, Rita

doi:10.1227/01.neu.0000245626.93215.f6

Cited by 64 publications

(47 citation statements)

References 19 publications

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“…Both groups showed TV shrinkage at the follow-up examinations: the size of the residual volumes were 89.6 ± 19.9% and 81.7 ± 6.6% for inoperable and 83.9 ± 21.6% and 75.0 ± 19.1% for operated patients at one-and two-year follow-up, respectively. These findings correspond with Astner et al [16] and Henzel et al [17] who also could not find any predictive correlation between TV shrinkage after RT and operability.…”

Section: Discussionsupporting

confidence: 90%

“…However, they did not observe any additional reduction after more than 72 months, which might be the effect of a smaller number of available MRIs in further follow-up. A significant TV shrinkage was detected by Henzel et al as well [17]. They prospectively observed 84 FSRT-treated patients with grade I meningiomas.…”

Section: Discussionmentioning

confidence: 83%

“…These photon techniques have already shown their positive effect on local control, disease-free (DFS) and OS rates without major toxicity [5][6][7][8][9][10]12,23]. Henzel et al could not demonstrate any correlation between the TV shrinkage and the delivered radiation doses [17]. They applied a median dose of 56 Gy (range 50.4-59.4 Gy).…”

Section: Discussionmentioning

confidence: 99%

“…In the past, several groups have evaluated the volumetric response of intracranial meningiomas after photon RT [16,17]. Up to now, no work has been published using particle therapy.…”

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confidence: 99%

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Volumetric response of intracranial meningioma after photon or particle irradiation

et al. 2016

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Background: Meningiomas are usually slow growing, well circumscribed intracranial tumors. In symptom-free cases observation with close follow-up imaging could be performed. Symptomatic meningiomas could be surgically removed and/or treated with radiotherapy. The study aimed to evaluate the volumetric response of intracranial meningiomas at different time points after photon, proton, and a mixed photon and carbon ion boost irradiation. Patients and methods: In Group A 38 patients received proton therapy (median dose: 56 GyE in 1.8-2 GyE daily fractions) or a mixed photon/carbon ion therapy (50 Gy in 2 Gy daily fractions with intensity modulated radiotherapy (IMRT) and 18 GyE in 3 GyE daily dose carbon ion boost). Thirty-nine patients (Group B) were treated by photon therapy with IMRT or fractionated stereotactic radiotherapy technique (median dose: 56 Gy in 1.8-2 Gy daily fractions). The delineation of the tumor volume was based on the initial, one-and two-year follow-up magnetic resonance imaging and these volumes were compared to evaluate the volumetric tumor response. Results: Significant tumor volume shrinkage was detected at one-and at two-year follow-up both after irradiation by particles and by photons. No significant difference in tumor volume change was observed between photon, proton or combined photon plus carbon ion boost treated patients. WHO grade and gender appear to be determining factors for tumor volume shrinkage. Conclusion: Significant volumetric shrinkage of meningiomas could be observed independently of the applied radiation modality. Long-term follow-up is recommended to evaluate further dynamic of size reduction and its correlation with outcome data.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

“…In the past, several groups have evaluated the volumetric response of intracranial meningiomas after photon RT [16,17]. Up to now, no work has been published using particle therapy.…”

mentioning

confidence: 99%

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Volumetric response of intracranial meningioma after photon or particle irradiation

et al. 2016

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“…In most series, the administered dose ranged between 50 and 57 Gy delivered in daily fractions of 1.8-2 Gy. The tumor control rates were similar for doses of 50-55 Gy or > 55 Gy 51,53,57,[59][60][61][62][63][64] . Doses below 50 Gy were associated with higher, mostly local recurrence rates 51,60 .…”

Section: Extent Of Resection (Eor) As Iis Defined By the Simpsonmentioning

confidence: 99%

EANO guidelines for the diagnosis and treatment of meningiomas

Goldbrunner

Minniti

Preusser

et al. 2016

The Lancet Oncology

691

599

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Although meningiomas are the most common intracranial tumours, the level of evidence to provide recommendations for the diagnosis and treatment of meningiomas is low compared with other tumours such as high-grade gliomas. The meningioma task force of the European Association of NeuroOncology (EANO) assessed the scientific literature and composed a framework of the best possible evidence-based recommendations for health professionals. The provisional diagnosis of meningioma is mainly made by MRI. Definitive diagnosis, including histological classification, grading, and molecular profiling, requires a surgical procedure to obtain tumour tissue. Therefore, in many elderly patients, observation is the best therapeutic option. If therapy is deemed necessary, the standard treatment is gross total surgical resection including the involved dura. As an alternative, radiosurgery can be done for small tumours, or fractionated radiotherapy in large or previously treated tumours. Treatment concepts combining surgery and radiosurgery or fractionated radiotherapy, which enable treatment of the complete tumour volume with low morbidity, are being developed. Pharmacotherapy for meningiomas has remained largely experimental. However, antiangiogenic drugs, peptide receptor radionuclide therapy, and targeted agents are promising candidates for future pharmacological approaches to treat refractory meningiomas across all WHO grades.

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