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- Title
Proton therapy for atypical meningiomas.
- Authors
McDonald, Mark; Plankenhorn, David; McMullen, Kevin; Henderson, Mark; Dropcho, Edward; Shah, Mitesh; Cohen-Gadol, Aaron
- Abstract
We report clinical outcomes of proton therapy in patients with World Health Organization grade 2 (atypical) meningiomas. Between 2005 and 2013, 22 patients with atypical meningiomas were treated to a median dose of 63 Gy (RBE) using proton therapy, as an adjuvant therapy after surgery (n = 12) or for recurrence or progression of residual tumor (n = 10). Six patients had presumed radiation-induced meningiomas, but none had received prior radiotherapy for their meningioma. The median follow-up time after radiation was 39 months (range 7-104) and all patients remain alive at last follow-up. The 5-year estimate of local control was 71.1 % (95 % CI 49.3-92.9 %). The 5-year estimate of local control was 87.5 % following a radiation dose >60 Gy (RBE), compared to 50.0 % for ≤60 Gy (RBE) (p = 0.038). The 5-year estimate of neuraxis dissemination was 5 % (95 % CI 0-14.6 %) and 6.2 % (95 % CI 0-18.2 %) for metastases outside of the central nervous system. Radiation necrosis was observed in one patient with a history of prior cranial irradiation. Fractionated proton therapy was associated with favorable tumor control rates for grade 2 meningiomas. Prospective studies are needed to define the optimal radiation dose for high-grade meningiomas.
- Subjects
MENINGIOMA; CANCER invasiveness; CANCER relapse; LONGITUDINAL method; RADIATION doses; HEALTH outcome assessment; PATIENTS; THERAPEUTICS
- Publication
Journal of Neuro-Oncology, 2015, Vol 123, Issue 1, p123
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-015-1770-9