Single session versus multisession stereotactic radiosurgery for the management of intracranial meningiomas: a systematic review and meta-analysis

Bin-Alamer, Othman; Alnefaie, Nada; Qedair, Jumanah T.; Chaudhary, Adhiraj; Hallak, Hana; Abdulbaki, Arif; Mallela, Arka N.; Palmisciano, Paolo; Gersey, Zachary C.; Legarreta, Andrew D.; Labib, Mohamed A.; Zada, Gabriel; Sheehan, Jason P.; Couldwell, William T.; Lunsford, L. Dade; Abou‐Al‐Shaar, Hussam

doi:10.1007/s11060-022-04112-6

Cited by 5 publications

(4 citation statements)

References 47 publications

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“…In the meta-analysis published in 2022, which included 20 studies and over 1400 patients, it was observed that 5-y results did not change when single fraction and multiple fractions schemes were compared. [16] In our study, no difference was observed in terms of OS and PFS with single or multi-fractionated RT. In our study, the main reason for the preference of multi-fraction treatments was the presence of larger tumors and tumors close to critical structures, as in other studies.…”

Section: Discussioncontrasting

confidence: 56%

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

DELİKGÖZ SOYKUT,

AKSAN,

ŞAVLI

et al. 2023

Journal of Contemporary Medicine

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Aim: Innovations in radiotherapy have paved the way for alternative approaches for the treatment of meningioma, and in this context, radiosurgery has begun to be used in the treatment of meningioma. This study aimed to examine the clinical results of radiosurgery in the treatment of meningioma and to show whether it achieves the main goals, especially in terms of the possibility of tumor control and the success of preventing progression. Materials and Methods: Primary, residual, and recurrent meningioma treated with stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) between 2013 and 2020 were evaluated retrospectively. Study endpoints were overall survival (OS), progression free survival (PFS), and local control (LC). Results: 73 patients and 81 lesions were analyzed. The median duration of the follow-up period was 49 months (range, 7–138 months). 5- and 7-y OS and PFS were 87.6%, 78.9%; 82.9% and 82.9%, respectively. The tumor control rate was 94.6%. In univariate analysis, gender (p=0.007), radiosurgery for recurrence (p=0.011) and number of lesions (p=0.030) were found to be factors affecting OS, and number of lesions (p

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Section: Discussioncontrasting

confidence: 56%

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

DELİKGÖZ SOYKUT,

AKSAN,

ŞAVLI

et al. 2023

Journal of Contemporary Medicine

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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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“…While chemotherapy has been documented to improve survival in malignant lesions, radiotherapy as a primary or adjuvant modality aims mainly to halt tumor progression. Studies that investigated the efficacy of radiotherapy for meningiomas and schwannomas reported high 10-year PFS rates of up to 90–98% [ 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. However, since different tumor types respond differently to various modalities, it is essential to tailor a personalized management plan based on the patient tumor pathology and their clinical condition.…”

Section: Discussionmentioning

confidence: 99%

Tumors Involving the Infratemporal Fossa: A Systematic Review of Clinical Characteristics and Treatment Outcomes

Bin-Alamer

Bhenderu²,

Palmisciano³

et al. 2022

Cancers

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Background: Infratemporal fossa (ITF) tumors represent various pathologies and are seldom described in the literature, reflecting their rarity. Here we review the literature on tumors invading ITF and describe patient characteristics, treatment strategies, and clinical outcomes. Methods: Relevant articles were retrieved from PubMed, Scopus, and Cochrane. A systematic review and meta-analysis were conducted on the clinical presentation, treatment protocols, and clinical outcomes. Result: A total of 27 articles containing 106 patients with ITF tumors (median tumor size: 24.3 cm3 [interquartile range, 15.2–42 cm3]) were included (median age: 46 years [interquartile range, 32–55 years]; 59.4% were males]). Of the confirmed tumor pathology data, schwannomas (n = 24; 26.1%) and meningiomas (n = 13; 14.1%) were the most common tumors. Facial hypoesthesia (n = 22; 18.5%), auricular/preauricular pain (n = 20; 16.8%), and headaches (n = 11; 9.2%) were the most common presenting symptoms. Of patients who had surgical resection (n = 97; 95.1%), 70 (73.7%) had transcranial surgery (TCS) and 25 (26.3%) had endoscopic endonasal surgery (EES). Among available details on the extent of resection (n = 84), gross-total resection (GTR) was achieved in 62 (73.8%), and 5 (6.0%) had biopsy only. Thirty-five (33.0%) patients had postoperative complications. Among cases with available data on reconstruction techniques (n = 8), four (50%) had adipofascial antero-lateral thigh flap, three (37.5%) had latissimus dorsi free flap, and one (12.5%) had antero-lateral thigh flap. Fourteen (13.2%) patients had adjuvant chemotherapy, and sixteen (15.1%) had adjuvant radiotherapy. During a median follow-up time of 28 months (IQR, 12.25–45.75 months), 15 (14.2%) patients had recurrences, and 18 (17.0%) patients died. The median overall survival (OS) time was 36 months (95% confidence interval: 29–41 months), and the 5-year progression-free survival (PFS) rate was 61%. Conclusion: Various tumor types with different biological characteristics invade the ITF. The present study describes patient demographics, clinical presentation, management, and outcomes. Depending on the tumor type and patient condition, patient-tailored management is recommended to optimize treatment outcomes.

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Single session versus multisession stereotactic radiosurgery for the management of intracranial meningiomas: a systematic review and meta-analysis

Cited by 5 publications

References 47 publications

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

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

Tumors Involving the Infratemporal Fossa: A Systematic Review of Clinical Characteristics and Treatment Outcomes

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