Fractionated radiotherapy and radiosurgery of intracranial meningiomas

Biau, J.; Khalil, T.; Verrelle, Pierre; Lemaire, Jean‐Jacques

doi:10.1016/j.neuchi.2014.10.112

Cited by 20 publications

(5 citation statements)

References 84 publications

(101 reference statements)

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“…299,300 Radiosurgery or fractionated radiotherapy may be used as an alternative to surgery. 301 Currently, no useful drugs have been found for routine clinical treatment of WHO grade 1 meningioma. Pay attention to whether the patients have neurological and cognitive dysfunction to avoid affecting their quality of life.…”

Section: Meningiomasmentioning

confidence: 99%

Signaling pathways in brain tumors and therapeutic interventions

Wang

Chen

et al. 2023

Sig Transduct Target Ther

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Brain tumors, although rare, contribute to distinct mortality and morbidity at all ages. Although there are few therapeutic options for brain tumors, enhanced biological understanding and unexampled innovations in targeted therapies and immunotherapies have considerably improved patients’ prognoses. Nonetheless, the reduced response rates and unavoidable drug resistance of currently available treatment approaches have become a barrier to further improvement in brain tumor (glioma, meningioma, CNS germ cell tumors, and CNS lymphoma) treatment. Previous literature data revealed that several different signaling pathways are dysregulated in brain tumor. Importantly, a better understanding of targeting signaling pathways that influences malignant behavior of brain tumor cells might open the way for the development of novel targeted therapies. Thus, there is an urgent need for a more comprehensive understanding of the pathogenesis of these brain tumors, which might result in greater progress in therapeutic approaches. This paper began with a brief description of the epidemiology, incidence, risk factors, as well as survival of brain tumors. Next, the major signaling pathways underlying these brain tumors’ pathogenesis and current progress in therapies, including clinical trials, targeted therapies, immunotherapies, and system therapies, have been systemically reviewed and discussed. Finally, future perspective and challenges of development of novel therapeutic strategies in brain tumor were emphasized.

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Section: Meningiomasmentioning

confidence: 99%

Signaling pathways in brain tumors and therapeutic interventions

Wang

Chen

et al. 2023

Sig Transduct Target Ther

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“…SRS and SRT have obtained similar results for tumor control, tumor volumetric changes, and functional outcomes. 53-56 In lesions >10 cm 3 , SRS has been associated with lower tumor control rates and higher morbidity, recording complications in up to 13%. 48,57 In this study, 30% of complications were in patients with meningiomas above this volume.…”

Section: Discussionmentioning

confidence: 99%

“…In general, radiation-induced neuropathy has been related to larger treated tumor volumes and higher doses. 45,47,48,52 Thus, Pollock et al 48 [53][54][55][56] In lesions >10 cm 3 , SRS has been associated with lower tumor control rates and higher morbidity, recording complications in up to 13%. 48,57 In this study, 30% of complications were in patients with meningiomas above this volume.…”

Section: Complications Of Srsmentioning

confidence: 99%

Long-term Experience of LINAC Single-Dose Radiosurgery for Skull Base Meningiomas: A Retrospective Single-Center Study of 241 Cases

Ortiz García,

Rodríguez Valero,

Jorques Infante

et al. 2023

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: Stereotactic radiosurgery (SRS) is increasingly applied to treat meningiomas, attributable to their increased incidence in older individuals at greater surgical risk. To evaluate the effectiveness of treatment with linear accelerator (LINAC)–based stereotactic radiosurgery in skull base meningiomas as either primary treatment or postresection adjuvant therapy. METHODS: This study included 241 patients diagnosed with skull base meningiomas treated by single-dose SRS, with a median age of 59 years. SRS was primary treatment in 68.1% (n = 164) and adjuvant treatment in 31.9% (n = 77), using LINAC (Varian 600, 6 MeV). The median tumor volume was 3.2 cm3, and the median coverage dose was 14 Gy. Bivariate and multivariate analyses were performed to determine predictive factors for tumor progression, clinical deterioration, and complications. Kaplan-Meier analysis was used for survival analysis. RESULTS: After the median follow-up of 102 months, the tumor control rate was 91.2% (n = 220). Progression-free survival rates were 97.07%, 90.1%, and 85.7% at 5, 10, and 14 years, respectively. Clinical improvement was observed in 56 patients (23.2%). In multivariate analysis, previous surgery (hazard ratio 3.8 [95%CI 1.136-12.71], P = .030) and selectivity (hazard ratio .21 [95%CI 0.066-0.677], P = .009) were associated with tumor progression and increased maximum dose (odds ratio [OR] 4.19 [95% CI 1.287-13.653], P = .017) with clinical deterioration. The permanent adverse radiation effect rate was 6.2% (n = 15) and associated with maximum brainstem dose >12.5 Gy (OR 3.36 [95% CI .866-13.03], P = .08) and cerebellopontine angle localization (OR 3.93 [95% CI 1.29-11.98], P = .016). CONCLUSION: Treatment of skull base meningiomas with single-dose SRS using LINAC is effective over the long term. Superior tumor control is obtained in patients without previous surgery. Adverse effects are related to localization in the cerebellopontine angle, and maximum brainstem radiation dose was >12.5 Gy.

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“…Another commonly used treatment is radiotherapy [7,8]. Fractionated Stereotactic Radiation Therapy (FSRT) [9] and external beam radiation therapy (EBT) [10] as adjuvant or de nitive therapies play a fundamental role in the treatment of these tumors, allowing to reduce the recurrence rate [11], resulting in high rates of progression-free survival [12][13][14]. This increasingly effective disease management prompted a different approach several years ago [15].…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive functioning and quality of life in patients receiving radiotherapy for intracranial meningiomas. Systematic review

González

Gonçalves

Perea

et al. 2022

Preprint

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This work is aimed at analyzing the neurocognitive functioning (NF) and the quality of life (QoL) of adult subjects with meningioma treated with primary and / or adjuvant radiotherapy.The following databases were searched: Academic Search Complete, CINAHL, Medline, Psychology Database, PsycInfo, PubMed, Scopus and Web of Science, from January 2020 to June 2021. 11 out of the 1992 articles initially identified met the inclusion criteria. An own registry protocol was applied to encode works features and quality of studies and journals where articles were published was evaluated via a self-made scale based on previously validated instruments. The results indicate that most of the studies that assessed NF did not show changes in various cognitive domains after the end of primary and / or adjuvant radiotherapy, nor in the follow-up period: 3, 6, and 12 months after the end of treatment. However, those that assessed QoL did observed a deterioration after the end of therapy, but an improvement during the follow-up: 3, 6, and 12 months after the end of treatment. In general, adult patients suffering from meningioma perform well in the long term (up to 12 months) after primary and / or adjuvant therapy, both in NF and QoL. Future research is necessary to study more deeply this scope of work since the results to date are heterogeneous.

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Fractionated radiotherapy and radiosurgery of intracranial meningiomas

Cited by 20 publications

References 84 publications

Signaling pathways in brain tumors and therapeutic interventions

Signaling pathways in brain tumors and therapeutic interventions

Long-term Experience of LINAC Single-Dose Radiosurgery for Skull Base Meningiomas: A Retrospective Single-Center Study of 241 Cases

Neurocognitive functioning and quality of life in patients receiving radiotherapy for intracranial meningiomas. Systematic review

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