[The results of radiotherapy in meningiomas with a high risk of recurrence. A retrospective analysis].
OBJECTIVE
Retrospective assessment of the efficacy of radiation therapy for meningiomas with high risk for local recurrence.


METHODS
Records of 67 patients with meningiomas treated from 1974 to 1995 at 2 centres were analyzed. Follow-up time ranged from 0.8 to 213 months (median: 61 months). Radiation therapy was given either after local failure or after biopsy or subtotal resection. The ratio between malignant (n = 20) and benign (n = 47) meningioma was 1:2.4. Median age of the patients was 55 years (7 to 77 years). Radiation treatment was given at 1.5 to 2 Gy per fraction to 36 to 79.5 Gy. Survival rates were calculated by the Kaplan-Meier method. Statistical comparisons were performed with the log-rank test and the Cox proportional hazards model. The Bonferroni method was used to correct for multiple comparisons.


RESULTS
Five- and 10-year disease-free survival rates were 82% +/- 5% (standard error) and 70% +/- 9%. Local control rates at 5 and 10 years were 78% +/- 5% and 68% +/- 9%. In uni- and multivariate analysis histology, sex, total dose and center showed no significant influence on the results. Patients age was significant for local control (univariate p = 0.02; multivariate p = 0.03) and disease-free survival (univariate/multivariate p = 0.04). The postoperative tumor burden had a significant influence of disease-free survival (multivariate p = 0.04). After Bonferroni correction no significant influence was observed. We did not observe late side effects, especially brain necrosis.


CONCLUSIONS
Despite of the negative selection of our patients we observed high survival- and local control rates after radiation therapy. This underscores the role of radiation therapy in the treatment of meningiomas with high risk of local failure.
Winkler
C
C
Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden.
Dornfeld
S
S
Schwarz
R
R
Friedrich
S
S
Baumann
M
M
D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008579:Meningioma / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors