Short Course Hypofractionated Radiotherapy for Frail or Elderly Patients With Meningioma

Sarhan, Nasim; Abduljabbar, Lulwah; Laperrière, Normand; Shultz, David; Asha, Mohammed; Zadeh, Gelareh; Millar, Barbara‐Ann; Tsang, Derek S.

doi:10.7759/cureus.8604

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…However, despite the shortage of radiotherapy resources during the crisis period, only 1 respondent chose hypofractionated radiotherapy in 2 case-scenarios. Since short-course hypofractionated radiotherapy and radiotherapy doses under 50 Gy result in poor disease control in grade 2 or 3 meningiomas [ 24 25 ], and most neuro-oncologists have limited experience in utilizing short-course hypofractionated radiotherapy in atypical meningiomas, our expert panel concluded 54–60 Gy as the optimal radiotherapy dose even in the crisis period as for non-crisis clinical settings.…”

Section: Discussionmentioning

confidence: 99%

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Survey About Specific Clinical Scenarios (Version 2023.1)

Kim

Wee

et al. 2023

Brain Tumor Res Treat

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Background During the coronavirus disease 2019 (COVID-19) pandemic, there was a shortage of medical resources and the need for proper treatment guidelines for brain tumor patients became more pressing. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future. As part II of the guideline, this consensus survey is to suggest management options in specific clinical scenarios during the crisis period. Methods The KSNO Guideline Working Group consisted of 22 multidisciplinary experts on neuro-oncology in Korea. In order to confirm a consensus reached by the experts, opinions on 5 specific clinical scenarios about the management of brain tumor patients during the crisis period were devised and asked. To build-up the consensus process, Delphi method was employed. Results The summary of the final consensus from each scenario are as follows. For patients with newly diagnosed astrocytoma with isocitrate dehydrogenase ( IDH )-mutant and oligodendroglioma with IDH -mutant/1p19q codeleted, observation was preferred for patients with low-risk, World Health Organization (WHO) grade 2, and Karnofsky Performance Scale (KPS) ≥60, while adjuvant radiotherapy alone was preferred for patients with high-risk, WHO grade 2, and KPS ≥60. For newly diagnosed patients with glioblastoma, the most preferred adjuvant treatment strategy after surgery was radiotherapy plus temozolomide except for patients aged ≥70 years with KPS of 60 and unmethylated MGMT promoters. In patients with symptomatic brain metastasis, the preferred treatment differed according to the number of brain metastasis and performance status. For patients with newly diagnosed atypical meningioma, adjuvant radiation was deferred in patients with older age, poor performance status, complete resection, or low mitotic count. Conclusion It is imperative that proper medical care for brain tumor patients be sustained and provided, even during the crisis period. The findings of this consensus survey will be a useful reference in determining appropriate treatment options for brain tumor patients in the specific clinical scenarios covered by the survey during the future crisis.

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Section: Discussionmentioning

confidence: 99%

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Survey About Specific Clinical Scenarios (Version 2023.1)

Kim

Wee

et al. 2023

Brain Tumor Res Treat

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“…The majority of meningiomas treated in our study received 50 Gy/25 Fr or 54 Gy/30 Fr (129/137, 94%) with only a minority receiving a hypofractionated regimen (40 Gy/15 Fr) or dose escalation (60 Gy/30 Fr). While hypofractionation has been found to be an effective strategy for some meningiomas post-operatively, our cohort did not include a sufficient number of patients to perform a matched analysis comparing this to conventional fractionation [19] , [20] , [21] . Dose escalation (to 60 Gy and beyond) has also been investigated but mostly in smaller studies and in the context of treating higher grade meningiomas (WHO grades 2 and 3), including those with subtotal resections [22] , [23] , [24] , [25] .…”

Section: Discussionmentioning

confidence: 99%

Outcomes and predictors of response to fractionated radiotherapy as primary treatment for intracranial meningiomas

Wang¹,

Landry²,

Nassiri³

et al. 2023

Clinical and Translational Radiation Oncology

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Short Course Hypofractionated Radiotherapy for Frail or Elderly Patients With Meningioma

Cited by 2 publications

References 17 publications

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Survey About Specific Clinical Scenarios (Version 2023.1)

The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Survey About Specific Clinical Scenarios (Version 2023.1)

Outcomes and predictors of response to fractionated radiotherapy as primary treatment for intracranial meningiomas

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