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Published on: February 6, 2019
Fractionated proton radiotherapy for benign cavernous sinus meningiomas
Jerry D Slater1, Lilia N Loredo, Arthur Chung
1Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA. jdslater@dominion.llumc.edu
Summary
Fractionated proton radiotherapy effectively controls benign cavernous sinus meningiomas, achieving high success rates in patients with grade 1 tumors and minimal toxicity, irrespective of prior surgery.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Cavernous sinus meningiomas are tumors that can cause significant neurological deficits.
- Treatment options include surgery, radiotherapy, or a combination.
- Proton therapy offers a precise radiation delivery method.
Purpose of the Study:
- To assess the efficacy of fractionated proton radiotherapy for benign cavernous sinus meningiomas.
- To evaluate disease control rates and toxicity.
- To determine if prior surgical intervention or histologic diagnosis impacts outcomes.
Main Methods:
- Retrospective analysis of 72 patients treated with proton therapy between 1991-2002.
- Patients had varying degrees of prior surgery and histologic verification.
- Median follow-up was 74 months; doses ranged from 57-59 Gy.
Main Results:
- Overall 5-year disease control rate was 96%.
- 99% control in patients with grade 1 or absent histology; 50% in atypical histology.
- Control rates remained high (95-96%) regardless of previous surgeries.
Conclusions:
- Fractionated proton radiotherapy provides excellent disease control for grade 1 cavernous sinus meningiomas.
- Treatment efficacy is maintained despite prior surgical history or lack of histologic confirmation.
- Primary proton therapy is a viable option for large lesions.
