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09-01-2012 | Surgery | Article

Single-fraction radiosurgery results positive for intracranial meningioma

Abstract

Free abstract

MedWire News: Single-fraction radiosurgery (SRS) provides good tumor control for patients with imaging-defined intracranial meningioma, a review has found.

The research, published in the International Journal of Radiation Oncology Biology Physics, followed-up 251 patients treated with SRS between 1990 and 2008 at the Mayo Clinic in Rochester, Minnesota, USA.

The patients were aged an average of 58.6 years and the majority had a tumor involving the skull base/tentorium (83.7%). The treatment volume was an average of 7.7 cm3, with a mean tumor margin dose of 15.8 Gy.

The patients were followed-up for an average of 62.9 months; at the last evaluation 224 patients were alive, 22 had died, and five had undergone tumor resection.

Tumor shrinkage was reported in 72.1% of patients and no change was recorded in 26.7% of patients. Three (1.2%) patients experienced in-field tumor progression 28, 145, and 150 months after treatment, respectively.

Local control was reported in 99.4% of patients after both 3 and 10 years. One patient required repeat SRS after developing distant progression after 105 months.

Surgery was required in five (2%) patients a median of 14 months after SRS, for facial numbness and pain, seizures, or headache.

Temporary and permanent radiation-related complications occurred in 3.2% and 9.2% of patients, respectively, most commonly cranial nerve deficits, headache, hemiparesis, and seizures. Radiation complications were reported in 8.3% and 11.5% of patients after 1 and 5 years, and in multivariate analysis were linked to convexity/falx tumors (hazard ratio [HR]=2.8), and increasing tumor volume (HR=1.05).

"Single-fraction SRS over the used dose range provides a high rate of tumor control for patients with presumed intracranial meningiomas," summarize Bruce Pollock and co-workers, from the Mayo Clinic.

"Patients with small- to medium-sized tumors involving the skull base had lowest risk of radiation-related complications."

Nevertheless, they conclude: "Surgical resection should remain the primary treatment for the majority of patients with symptomatic or enlarging dural-based masses over the cerebral convexities."

MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Lynda Williams

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