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Adjuvant combined modality therapy for malignant meningiomas

M C Chamberlain1

  • 1University of California, San Diego, USA.

Journal of Neurosurgery
|May 1, 1996
PubMed
Summary

Malignant meningiomas treated with surgery, radiotherapy, and chemotherapy (cyclophosphamide, adriamycin, vincristine) showed acceptable toxicity. This combined approach for aggressive brain tumors offered a modest survival improvement over surgery alone.

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Area of Science:

  • Neuro-oncology
  • Neurosurgery
  • Radiation Oncology

Background:

  • Malignant meningiomas are rare, aggressive primary brain tumors with limited adjuvant treatment data.
  • Optimal treatment strategies for these challenging tumors remain under investigation.

Purpose of the Study:

  • To evaluate the efficacy and toxicity of a combined modality treatment protocol for primary malignant meningiomas.
  • To assess outcomes including tumor response, progression-free survival, and overall survival.

Main Methods:

  • Prospective study of 14 patients with primary malignant meningiomas.
  • Treatment involved surgery (gross-total or subtotal resection) followed by involved-field radiotherapy (median 60 Gy).
  • Adjuvant chemotherapy with cyclophosphamide, adriamycin, and vincristine (CAV) was administered post-radiotherapy.

Main Results:

  • Neuroradiographic response: 3 partial responses, 11 stable disease.
  • Median time to tumor progression: 4.6 years.
  • Median survival: 5.3 years.
  • Treatment was associated with manageable toxicity, including myelosuppression requiring dose adjustments or interruptions in some patients.

Conclusions:

  • Combined modality therapy (surgery, radiotherapy, CAV chemotherapy) is a viable option for malignant meningiomas.
  • This approach demonstrates acceptable toxicity and a modest survival benefit compared to surgery alone.
  • Further research is warranted to optimize treatment for these aggressive tumors.

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