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Hypofractionated stereotactic radiation therapy in skull base meningiomas
Pierina Navarria1, Federico Pessina2, Luca Cozzi3
1Radiosurgery and Radiotherapy Department, Istituto Clinico Humanitas Cancer Center Rozzano Milano, Via Manzoni 56, 20089, Rozzano, Milano, Italy.
Journal of Neuro-Oncology
|June 5, 2015
Summary
Hypo-fractionated stereotactic radiation treatment (HSRT) effectively manages skull base meningiomas, offering symptom relief and tumor control. This feasible approach shows promise for patients unsuitable for surgery or standard radiation therapy.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Skull base meningiomas pose management challenges, particularly for patients ineligible for surgery or standard radiation.
- Hypo-fractionated stereotactic radiation treatment (HSRT) offers a precise, dose-escalated radiation delivery method.
Purpose of the Study:
- To evaluate the efficacy and safety of HSRT for skull base meningiomas.
- To assess symptom relief, local tumor control, and toxicity in patients treated with HSRT.
Main Methods:
- A cohort of 26 patients with skull base meningioma received HSRT (30 Gy in 5 fractions) using volumetric modulated arc therapy (RapidArc).
- Tumor locations, treatment history, follow-up duration (median 24.5 months), and clinical outcomes were analyzed.
Main Results:
- Complete or partial symptom remission was achieved in all 18 symptomatic patients.
- No severe neurologic toxicity (Grade III-IV) was observed.
- Tumor volume reduction occurred in 38% of patients, with 62% demonstrating stable disease; no local progression was noted.
Conclusions:
- HSRT is a feasible and effective treatment for skull base meningiomas in selected patients.
- The treatment provides durable local control and significant symptom improvement with minimal toxicity.
- Routine application of HSRT may be considered for patients unsuitable for conventional treatments.
