Outcomes Following Proton Radiation for Pediatric Meningiomas

Area of Science:

• Pediatric neuro-oncology
• Radiation oncology
• Tumorigenesis

Background:

• Pediatric meningiomas are rare, accounting for 2% of pediatric CNS tumors.
• Distinct from adult meningiomas, they often associate with neurofibromatosis-2 (NF2).
• Limited outcome data exists for pediatric meningiomas treated with radiation therapy (RT).

Purpose of the Study:

• To evaluate the long-term outcomes and toxicities of pediatric meningiomas treated with proton therapy (PT).
• To contribute to the limited dataset on radiation therapy for pediatric meningiomas.

Main Methods:

• Retrospective analysis of 18 pediatric patients treated with PT (2006-2024).
• Doses ranged from 50.4-59.4 Gy in 1.8 Gy/fraction, based on tumor grade (WHO Grade I/II).
• Kaplan-Meier analysis for progression-free survival (PFS), local recurrence, and overall survival (OS); toxicity assessment.

Main Results:

• Median follow-up was 8.5 years; 10-year local control was 87%, PFS 75%, OS 94%.
• Two deaths occurred: one from radiation-associated second neoplasm, one from cerebral vasculopathy.
• Observed toxicities included hearing loss, cataract formation, and endocrinopathy; no progressive vision loss.

Conclusions:

• Long-term disease control in pediatric meningioma patients treated with PT is encouraging and comparable to adult data.
• Proton therapy (PT) demonstrated effective disease control for pediatric meningiomas.
• Serious radiation toxicity was observed, underscoring the importance of vigilant toxicity monitoring in pediatric RT.