title: Carbon ion radiation therapy for high-risk meningiomas.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, University Hospital of Heidelberg, 69120 Heidelberg, Germany. Stephanie.Combs@med.uni-heidelberg.de
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Combs
authors.forename: Christian
authors.initials: C
authors.lastname: Hartmann
authors.forename: Anna
authors.initials: A
authors.lastname: Nikoghosyan
authors.forename: Oliver
authors.initials: O
authors.lastname: Jäkel
authors.forename: Christian P
authors.initials: CP
authors.lastname: Karger
authors.forename: Thomas
authors.initials: T
authors.lastname: Haberer
authors.forename: Andreas
authors.initials: A
authors.lastname: von Deimling
authors.forename: Marc W
authors.initials: MW
authors.lastname: Münter
authors.forename: Peter E
authors.initials: PE
authors.lastname: Huber
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Daniela
authors.initials: D
authors.lastname: Schulz-Ertner
mesh_terms: 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
chemical_list: D002244:Carbon