Single dose versus fractionated stereotactic radiotherapy for meningiomas.
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
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.


CONCLUSIONS
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.
Departments of Therapeutic Radiology-Radiation Oncology, University of Minnesota Hospital and Clinic, Minneapolis, MN, USA.
Simon S
SS
Lo
Kwan H
KH
Cho
Walter A
WA
Hall
Ronald J
RJ
Kossow
Wilson L
WL
Hernandez
Kim K
KK
McCollow
Bruce J
BJ
Gerbi
Patrick D
PD
Higgins
Chung K
CK
Lee
Kathryn E
KE
Dusenbery
D019583:Dose Fractionation, Radiation; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D008579:Meningioma / Q000532:radiotherapy* / Q000601:surgery*; D011379:Prognosis; D016634:Radiosurgery / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome