Atypical and Malignant Meningioma: Outcome and Prognostic Factors in 119 Irradiated Patients. A Multicenter, Retrospective Study of the Rare Cancer Network

Pasquier, David; Bijmolt, S.; Veninga, Theo; Rezvoy, N.; Villà, Salvador; Krengli, Marco; Weber, Damien Charles; Baumert, Brigitta G.; Canyılmaz, Emine; Yalman, Deniz; Szutowicz, Ewa; Tzuk-Shina, Tzahala; Mirimanoff, R.O.

doi:10.1016/j.ijrobp.2007.12.020

Cited by 208 publications

(165 citation statements)

References 17 publications

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“…14 Age and KPS were found to be the most significant predictors of meningioma outcome. 16 Compared with these patients, the patients in the current study were similar with regard to age (median age, 57 years vs 58 years in the previous study) and KPS (median, 70 vs 80 in the previous study). The median duration of response for the 6 patients in the current study was 2.0 months compared with previously published data that demonstrated a median duration of response of 5.0 months.…”

Section: Resultssupporting

confidence: 68%

Pulmonary metastases in patients with recurrent, treatment‐resistant meningioma

Alexandru

Glantz

Kim

et al. 2011

Cancer

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BACKGROUND:Meningioma is the most common extra-axial primary intracranial tumor in adults that rarely metastasizes outside of the central nervous system (CNS). Among recognized sites of metastases, the lung is the most common, but the importance of lung metastases relative to prognosis is unknown. 111 Indium ( 111 In)-octreotide scintigraphy (octreotide scanning) is a valuable imaging modality with which to evaluate intracranial meningiomas and their response to treatment with somatostatin analogues and has the potential to identify extracranial metastatic disease. METHODS: In this retrospective multicenter study, adult patients treated for recurrent meningioma were identified. These patients underwent 111 In-octreotide positron emission tomography/computed tomography imaging (octreotide scintigraphy) and were found to have positive octreotide uptake in their lungs. RESULTS: Six cases were identified with recurrent meningioma (after surgery, radiotherapy, and at least 1 chemotherapy agent) and pulmonary lesions by octreotide scintigraphy. Biopsy of a pulmonary lesion in 1 patient confirmed the diagnosis of metastatic meningioma. Patients with metastatic pulmonary involvement identified by 111 In-octreotide scintigraphy in this case series had an overall survival of 6 months, which is less than that reported from previously published series of patients with unknown systemic disease status. CONCLUSIONS: 111 In-octreotide scintigraphy is useful for assessing both CNS disease and extracranial metastases. The presence of pulmonary metastases appears to negatively affect survival in patients with recurrent meningioma. The usefulness of 111 In-octreotide scintigraphy should be considered in staging patients with recurrent meningioma who are considered for further treatment. A prospective study to confirm this finding is warranted.

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Section: Resultssupporting

confidence: 68%

Pulmonary metastases in patients with recurrent, treatment‐resistant meningioma

Alexandru

Glantz

Kim

et al. 2011

Cancer

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“…Not all series have seen an apparent benefit to treatment intensification for high-grade meningiomas [11]. A large multicenter retrospective review by the Rare Cancer Network on 119 patients with high-grade meningiomas did not identify a dose response within the ranges utilized [24]. However, a recent systematic review of the literature summarizes that the majority of published studies on grade 2 and 3 meningiomas support an association between higher dose and improved clinical outcomes [9].…”

Section: Discussionmentioning

confidence: 99%

Proton therapy for atypical meningiomas

et al. 2015

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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.3

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“…The effectiveness of radiotherapy was assessed in a retrospective study of 119 patients with atypical (69%) or malignant (31%) meningiomas treated with external beam radiotherapy (EBRT) after initial complete resection in 94 cases and for recurrence in 25 patients (Pasquier et al, 2008). The overall survival rates at 5 and 10 years were 65% and 51%, respectively.…”

Section: Effectiveness Of Radiation Therapymentioning

confidence: 99%

“…Prognosis worsens with the more poor differentiation of the tumors (Palma et al, 1997;Park & McLaren, 2009;Pasquier et al, 2008). High mitotic rate is a significant prognostic factor, as well as the poor Karnofski performance status (Pasquier et al, 2008).…”

Section: Prognosismentioning

confidence: 99%