Linac radiosurgery for benign meningiomas

Shafron, David; Friedman, William A.; Buatti, John M.; Bova, Frank J.; Mendenhall, William M.

doi:10.1016/s0360-3016(98)00391-5

Cited by 90 publications

(32 citation statements)

References 56 publications

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“…[30][31][32][33][34][35][36][37][38][39][40][41][42][43] There does not seem to be any significant difference in local control rates between the Gamma Knife and LINAC-based SRS series.…”

Section: Stereotactic Radiotherapymentioning

confidence: 99%

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Single Dose versus Fractionated Stereotactic Radiotherapy for Meningiomas

Cho

Hall

et al. 2002

Can. j. neurol. sci.

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240Meningiomas constitute approximately 20% of all primary intracranial tumors.1,2 Tumor grade rather than histologic subtype bears clear prognostic importance. [3][4][5][6][7][8][9] Complete surgical excision, if achievable, can produce excellent results without adjunctive therapy. [9][10][11] However, meningiomas may recur after surgery and curative resection can result in significant morbidity because of strategic tumor location and old age. [12][13][14][15] Stereotactic radiosurgery (SRS) can deliver a single high dose of radiation to a localized area in the brain for the treatment of meningiomas that are unresectable, recurrent or residual after surgery. However, large tumors and tumors adjacent to vital ABSTRACT: Objective: To evaluate the safety and efficacy of stereotactic radiosurgery (SRS) compared to fractionated stereotactic radiation therapy (FSRT) for meningiomas treated over a seven year period. Methods and materials: Of the 53 patients (15 male and 38 female) with 63 meningiomas, 35 were treated with SRS and the 18 patients with tumors adjacent to critical structures or with large tumors were treated with FSRT. The median doses for the SRS and the FSRT groups were 1400 cGy (500-4500 cGy) and 5400 cGy (4000-6000 cGy) respectively. Median target volumes for SRS and FSRT were 6.8 ml and 8.8 ml respectively. The median follow-up for the SRS and FSRT groups were 38 months (4.1-97 months) and 30.5 months (6.0-63 months) respectively. Results: The five-year tumor control probability (TC) for benign versus atypical meningiomas were 92.7% vs. 31% (P=.006). The three-year TC were 92.7% vs. 93.3% for SRS vs. FSRT groups respectively (P=.62). For benign meningiomas, the three-year TC were 92.9% vs. 92.3% for the SRS group (29 patients) vs. FSRT group (14 patients) respectively (P=.77). Two patients in the SRS group and one in the FSRT group developed late complications. Conclusion: Preliminary data suggest that SRS is a safe and effective treatment for patients with benign meningiomas. Fractionated stereotactic radiation therapy with conventional fractionation appeared to be an effective and safe treatment alternative for patients not appropriate for SRS. A longer follow-up is required to determine the long-term efficacy and the toxicity of these treatment modalities.RÉSUMÉ: Dose unique versus radiothérapie stéréotaxique fractionnée dans le traitement des méningiomes. Objectif: Évaluer la sécurité et l'efficacité de la radiochirurgie stéréotaxique (RCS) comparée à la radiothérapie stétéotaxique fractionnée (RTSF) dans le traitement des méningiomes sur une période de sept ans. Méthodes et matériels: Parmi les 53 patients (15 hommes et 38 femmes) atteints de 63 méningiomes, 35 ont été traités par RCS et 18, dont la tumeur était adjacente à des structures critiques ou était volumineuse, ont été traités par RTSF. Les doses médianes pour le groupe RCS et le groupe RTSF étaient de 1400 cGy (500 à 4500 cGy) et 5400 cGy (4000 à 6000 cGy) respectivement. Les volumes cibles médians pour les groupes RCS et RTSF étaient...

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“…[30][31][32][33][34][35][36][37][38][39][40][41][42][43] There does not seem to be any significant difference in local control rates between the Gamma Knife and LINAC-based SRS series.…”

Section: Stereotactic Radiotherapymentioning

confidence: 99%

“…Regarding the tumor response after treatment, data in the literature showed tumor shrinkage rates ranging from 23 to 56% 30,33,40,41 after SRS. For FSRT, the Heidelberg group reported a partial tumor regression rate of 14% but they defined partial tumor regression as a reduction of tumor volume by at least 50%.…”

Section: Stereotactic Radiotherapymentioning

confidence: 99%

Single Dose versus Fractionated Stereotactic Radiotherapy for Meningiomas

Cho

Hall

et al. 2002

Can. j. neurol. sci.

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“…No entanto, nos tumores induzidos por radioterapia, o tratamento convencional encontra-se comprometido devido às doses moderadamente altas recebidas previamente 10 . Nesses casos, existe a opção de se tratar através de irradiação localizada em baixas doses por meio da radiocirurgia [20][21][22][23] .…”

Section: Discussionunclassified

“…Devido à maior propensão desses tumores à recorrência, recomenda-se uma margem ampla de ressecção óssea e da dura-máter durante o procedimento cirúrgico (grau I da escala de Simpson) 3,5 , podendo ser realizado tratamento complementar com radiocirurgia [20][21][22][23][24][25] . Recentemente, foram relatados bons resultados a longo prazo com o uso de hidroxiuréia em meningeomas benignos irressecáveis e recorrentes, porém sua eficácia não é significativa para meningeomas malignos e atípicos 4,25 .…”

Section: Discussionunclassified

Meningeoma pós-radioterapia

Barboza¹,

Panagopoulos²,

Lancellotti³

et al. 2006

Arq. Neuro-Psiquiatr.

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Os meningeomas são neoplasias derivadas das células aracnóideas, sendo sua origem ligada a alterações genéticas idiopáticas (deleção do braço longo do cromossomo 22), doenças predisponentes à sua formação e indução por radioterapia. Relata-se o caso de um homem de 50 anos com meningeoma pós-radioterapia diagnosticado 20 anos após o tratamento de um oligodendroglioma. Os critérios que suportam o diagnóstico de meningeoma induzido por radioterapia são discutidos, assim como é revisada a literatura pertinente ao assunto.

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“…For SRS, minimum target doses, covering the surface of the lesion, fall in the range of 13 -16 Gy (10,11,12,13,14,16,24 For HSRT, total doses in the region of 24 -40 Gy, given in 3-5 fractions have been used (18,51). FSRT doses fall in the range of 50 -56 Gy at 1.8 to 2 Gy per fraction.…”

Section: Grade I Meningiomasmentioning

confidence: 99%

Radiation Therapy in the Management of Meningiomas

Vernimmen¹

2012

Meningiomas - Management and Surgery

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Linac radiosurgery for benign meningiomas

Cited by 90 publications

References 56 publications

Single Dose versus Fractionated Stereotactic Radiotherapy for Meningiomas

Single Dose versus Fractionated Stereotactic Radiotherapy for Meningiomas

Meningeoma pós-radioterapia

Radiation Therapy in the Management of Meningiomas

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