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Linear Accelerator-Based Stereotactic Radiotherapy for Low-Grade Meningiomas: Improved Local Control With
Rodney E Wegner1, Shaakir Hasan1, Stephen Abel1
1Allegheny Health Network Cancer Institute, Division of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA, USA.
Journal of Central Nervous System Disease
|May 10, 2019
Summary
Hypofractionated stereotactic radiotherapy (SRT) offers high local control rates for meningioma treatment. This approach, involving fewer, larger radiation doses, demonstrated improved outcomes compared to single-fraction treatments.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Meningioma is a common, typically benign brain tumor.
- Treatment options include observation, surgery, and radiation therapy.
- Hypofractionated radiation is an evolving treatment modality.
Purpose of the Study:
- To evaluate the 10-year experience of treating meningiomas using a hypofractionated approach.
- To assess local control rates and toxicity of stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (SRT).
Main Methods:
- Retrospective review of 56 patients treated between 2008 and 2017.
- Patients received either SRS (single fraction) or hypofractionated SRT (multiple fractions).
- Analysis focused on local control and toxicity, including radionecrosis and symptomatic recurrence.
Main Results:
- High local control rates at 2 and 5 years (90% and 88% respectively).
- Hypofractionated SRT showed improved 2-year local control (91%) compared to SRS (80%, P=.009).
- Minimal toxicity observed, with rare instances of symptomatic radionecrosis or recurrence requiring intervention.
Conclusions:
- Hypofractionated SRT is an effective treatment for meningiomas, achieving high local control.
- This approach is associated with low toxicity rates.
- Fractionation of radiation dose appears to enhance local tumor control.
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