Normofractionated stereotactic radiotherapy versus CyberKnife-based hypofractionation in skull base meningioma: a German and Italian pooled cohort analysis

Conti, Alfredo; Senger, Carolin; Acker, Güliz; Kluge, Anne; Pontoriero, Antonio; Cacciola, Alberto; Pergolizzi, Stefano; Germanò, Antonino; Badakhshi, Harun; Kufeld, Markus; Meinert, Franziska; Nguyen, Phuong; Loebel, Franziska; Vajkoczy, Peter; Budach, Volker; Kaul, David

doi:10.1186/s13014-019-1397-7

Cited by 27 publications

(11 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We confirmed that radiosurgery with Gamma, Tomo, and CK is effective and safe in controlling most intracranial meningiomas. The crude radiographic control rate was 96%, which agrees with other series using different schemes of radiosurgery [4,[21][22][23][24][25][26] at the same time interval of follow-up, and complications were mainly mild in less than 10% of the series.…”

Section: Discussionsupporting

confidence: 88%

Multiplatform Radiosurgery for Intracranial Meningiomas and Dose to the Dural Tail

Lovo¹,

Moreira²,

Navarro

et al. 2021

Cureus

View full text Add to dashboard Cite

Introduction Meningiomas are extra-axial central nervous system tumors. Complete resection is often curative with macroscopically complete removal of the tumor, excision of its dural attachment, and any abnormal bone. Radiosurgery is also an option for high-risk patients or in patients with surgically residual disease. Dural tail is a typical radiological sign on contrast-enhanced MRI; it can contain tumor cells or be a reaction due to vascular congestion and edema. Radiosurgical planning treatment varies regarding the identification and coverage of the dural tail. This study aimed to retrospectively analyze a series of 143 patients with WHO Grade I meningiomas treated with different radiosurgical platforms, and dosing parameters focused on planning and dose delivery to the dural tail. Methods From February 2011 to July 2020, 143 patients with histologically confirmed or radiologically assumed WHO Grade I meningiomas were treated using rotating gamma-ray Infini™ (Gamma [MASEP Medical Science Technology Development Co., Shenzhen, China]), TomoTherapy® (Tomo [Accuray Inc., Sunnyvale, CA]), and CyberKnife® (CK [Accuray Inc.]). All plans were retrospectively reviewed to establish the maximum distance (MaxDis) from the prescription dose to the end of the dural tail and the minimum dose at the dural tail (MinDoseT) at this point. We also established the midpoint distance (MPDis) from the prescription dose to MaxDis and the dose at this point (MPDose). Plans were further distinguished when the physician intended to cover the dural tail versus when not. Patients and tumor response were assessed by imaging and clinical and phone call evaluations. Results Of the 143 patients, 81 were treated using Gamma, 34 using Tomo, and 28 using CK. Eighty patients were eligible for follow-up, of whom 58 (72.5%) had an unmistakable dural tail sign. Median follow-up was 1,118 days (range 189-3,496), mean age was 54.5 (range 19-90), and 61 were women, and 19 were men. Overall tumor volume was 6.5 cc (range 0.2-59); mean tumor volumes by different platforms were 2.4, 9.45, and 8 cc; dose prescribed and mean tumor coverage were 14 Gy and 92%, 14.5 Gy and 95%, and 14 Gy and 95.75% with Gamma, Tomo, and CK, respectively. The dural tail was drawn and planned with an attempt to treat in 18 patients (31%); the mean MaxDis, MinDoseT, MPDis, and MPDose were 9.0 mm, 2 Gy, 4.5 mm, and 10.6 Gy, respectively. At last follow-up, tumor control was achieved in 96% of patients for the whole series, and there were no statistical variations regarding tumor volume, dose, conformality, or control when stereotactic radiosurgery was used to cover the dural tail versus when it was not (p=0.105). One patient experienced a Grade 4 Radiation Therapy Oncology Group toxicity as an adverse radiation effect that required surgery, and 11 (7.6%) experienced a Grade 1 toxicity. Conclusions This is our preliminary report regarding the efficacy of radiosurgery for meningiomas using diverse pl...

show abstract

Section: Discussionsupporting

confidence: 88%

Multiplatform Radiosurgery for Intracranial Meningiomas and Dose to the Dural Tail

Lovo¹,

Moreira²,

Navarro

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…From a similar study where CKRT outcome was assessed on the skull base meningiomas, 1-, 3-, and 10-year LCR were 99.4, 96.8, and 80.3% respectively, which was comparable to our results. [1] Other study on intracranial meningiomas showed 2 year LCR of 81%, which was a bit lower than ours (93.8%). [8] On the other hand, gamma knife radiation surgery (GKS) on the sellar and parasellar meningiomas showed LCR of 98%, 88%, and 82% at 3-, 5-, and 10-year respectively.…”

Section: Radiological Outcome Of Ckrtcontrasting

confidence: 75%

“…[15,1] Although many reports exist regarding on the gamma knife radiation treatment, few large series reports regarding on the CyberKnife radiation treatment (CKRT) exist. [1] CyberKnife is a robotic frameless radiosurgery system equipped with real-time imaging guidance, which can deliver non-surgical multisession stereotactic treatments and automated targeting correction with sub-millimeter accuracy. [4,3] Here we report our facility's outcome of CKRT on the central skull base meningiomas (CSMs).…”

Section: Introductionmentioning

confidence: 99%

The Long-Term Outcome of Cyberknife Radiotherapy for Central Skull Base Meningiomas: A Single-Center Experience

Hong¹,

Sato²,

Kagawa³

et al. 2021

Preprint

View full text Add to dashboard Cite

Few reports exist demonstrating the effects of CyberKnife radiotherapy (CKRT) on the central skull base meningiomas (CSMs). Retrospective analysis of 113 patients were performed. The median age was 62 (IQR 50 – 72) years old, and 78 patients (69%) were female. Upfront CKRT was performed in 41 (36%), where 17 (15%) patients were asymptomatic. The other CKRT was for postoperative adjuvant therapy in 32 (28%), and for the recurrent or relapsed tumors in 40 (35%) patients. Previous operation was done in 74 patients (66%). Among the available pathology in 46 patients, 37 (80%) were WHO grade I, 8 (17%) were grade II, and 1 (2%) were grade III. The median prescribed dose covered 95% of the planning target volume was 2500 (IQR 2100 – 2500) cGy and the median target volume was 9.5 (IQR 3.9 – 16.9) cm3. The median PFS was 48 (IQR 23 – 73) months and 84% and 78% were free of tumor progression at five, and 10 years respectively. The median follow-up was 49 (IQR 28 – 83) months. PFS was better in grade I than grade II (p = 0.02). No other baseline factors including the history of previous operation was associated with PD or PFS. Adverse events of radiation therapy were radiation- induced optic neuropathy (0.9%), and cerebral edema (4.4%). Asymptomatic cavernous carotid stenosis was found in three (2.7%), five (4.4%) underwent ventriculoperitoneal shunt placement for normal pressure hydrocephalus, and five (4.4%) died. CKRT is useful for the management of CSMs with low rate of adverse events.

show abstract

“…The treatment decision-making algorithm proposed during the COVID-19 pandemic is given in Figure 1. The suggested treatment options for brain tumours [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] are enlisted in Table 1.…”

Section: Specific Scenariosmentioning

confidence: 99%

Radiotherapeutic management of brain tumours during the COVID-19 pandemic

et al. 2020

View full text Add to dashboard Cite

Aim: The coronavirus disease (COVID-19) pandemic is bound to put tremendous pressure on the existing healthcare system. This aim of this technical note is to help in triaging patients with brain tumours who are sent for radiotherapy during this pandemic and to provide safe and evidence-based care. Materials and Methods: Published data for this review were identified by systematically searching PubMed database from November 2007 onwards with the following Medical Subject Heading (Mesh) terms ‘Brain tumours’, ‘COVID-19’, ‘coronavirus’, ‘SARS-nCoV-2’, ‘Radiotherapy’, ‘Guidelines’ ‘hypofractionation’ using Boolean search algorithm. Articles in English language were reviewed. Results: We tried to apply the as low as reasonable achievable (ALARA) principle in triaging and management of patients for radiotherapy. We identified protocols which have hypofractionated regimens (reducing patient visits to hospital, time spent in treatment console) with similar outcomes when compared to conventional fractionated regimens and not overburdening the healthcare facility. We also identified the tumours for which we could safely avoid or delay the initiation of radiotherapy. Conclusion: Treatment decisions made during the COVID-19 pandemic rely on the safety first/do no harm principle and evidence-based prioritisation of cases for triage. This article is a tool to aid in triaging and prioritising brain tumour patient management. This is for consideration during the pandemic only and certainly not as a strategy for permanent practice change.

show abstract

Normofractionated stereotactic radiotherapy versus CyberKnife-based hypofractionation in skull base meningioma: a German and Italian pooled cohort analysis

Cited by 27 publications

References 53 publications

Multiplatform Radiosurgery for Intracranial Meningiomas and Dose to the Dural Tail

Multiplatform Radiosurgery for Intracranial Meningiomas and Dose to the Dural Tail

The Long-Term Outcome of Cyberknife Radiotherapy for Central Skull Base Meningiomas: A Single-Center Experience

Radiotherapeutic management of brain tumours during the COVID-19 pandemic

Contact Info

Product

Resources

About