Carbon ion radiation therapy for high-risk meningiomas.
BACKGROUND
We analyzed outcome after a carbon ion boost in combination with precision photon radiation therapy in patients with meningiomas.


METHODS
Ten patients with meningiomas were treated with carbon ion RT as part of a Phase I/II trial. Carbon ion RT was conducted in conjunction with fractionated stereotactic RT (FSRT) or intensity-modulated RT (IMRT). Eight patients were treated as primary RT, in 2 patients carbon ion RT was performed as re-irradiation. Carbon ion RT was applied with a median dose of 18 GyE, and photon RT was applied with a median dose of 50.4 Gy. Two patients with a history of former irradiation received 18GyE of carbon ion RT and a reduced dose of photon treatment.


RESULTS
The median follow-up time was 77 months. Five patients died during follow-up, of which four died of tumor progression. In the group treated in the primary situation, actuarial survival rates after RT were 75% and 63% at 5 and 7 years. After re-irradiation, both patients died at 10 and 67 months, respectively. Actuarial local control rates after primary RT were 86% and 72% at 5 and 7 years. Two patients developed tumor recurrence after re-irradiation, 6 and 67 months after treatment.


CONCLUSIONS
In conclusion, carbon ion radiation shows promising results in patients with atypical or anaplastic meningiomas. Further evaluation in a larger, prospective study in comparison to proton RT or modern photon RT is needed to corroborate these results.
Combs
Stephanie E
SE
Department of Radiation Oncology, University Hospital of Heidelberg, 69120 Heidelberg, Germany. Stephanie.Combs@med.uni-heidelberg.de
Hartmann
Christian
C
Nikoghosyan
Anna
A
Jäkel
Oliver
O
Karger
Christian P
CP
Haberer
Thomas
T
von Deimling
Andreas
A
Münter
Marc W
MW
Huber
Peter E
PE
Debus
Jürgen
J
Schulz-Ertner
Daniela
D
D000328:Adult; D000368:Aged; D002244:Carbon; D005260:Female; D063193:Heavy Ion Radiotherapy; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008579:Meningioma / Q000145:classification / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D017785:Photons / Q000627:therapeutic use; D050397:Radiotherapy, Intensity-Modulated; D012306:Risk
D002244:Carbon