title: A comparative study of stereotactic radiosurgery, hypofractionated, and fractionated stereotactic radiotherapy in the treatment of skull base meningioma.
abstract: OBJECTIVE
  To compare the outcomes of skull base meningiomas treated with stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy (hFSRT), and fractionated stereotactic radiotherapy (FSRT).
  
  
  METHODS
  A total of 220 basal meningiomas in 213 patients were treated using SRS (N=55), hFSRT (N=22), and FSRT (N=143). The median age was 59 years (28 to 84 y). Prior surgery was performed in 74 cases; 39 patients received adjuvant radiotherapy after incomplete resection and 35 patients received salvage radiotherapy after tumor progression. In 146 cases, radiation was the primary therapy. Ten patients had World Health Organization II or III meningiomas.
  
  
  RESULTS
  The median follow-up was 32 months (7 to 97 mo). Median tumor volume was 2.8 cm (0.10 to 16.94 cm), 4.8 cm (0.88 to 20.38 cm), and 11.1 cm (0.43 to 214.00 cm) and the median dose was 1250 cGy in 1 fraction to the 80% isodose line (IDL), 2500 cGy in 5 fractions to the 90% IDL, and 5040 cGy in 28 fractions to the 90% IDL for the SRS, hFSRT, and FSRT groups, respectively. Radiographic control was achieved in 91%, 94%, and 95% (P=0.25), whereas clinical response was seen in 89%, 100%, and 91% (P=0.16) in the SRS, hFSRT, and FSRT groups, respectively.
  
  
  CONCLUSIONS
  There is no significant difference in the radiographic and clinical response in patients with skull base meningioma treated with SRS, hFSRT, or FSRT and thus gives the clinician the impetus to tailor treatment techniques to the location and size of the tumor at presentation.
authors.affiliation: *Department of Radiation Oncology, Kaiser Permanente Los Angeles Medical Center †Southern California Permanente Medical Group ‡UCLA David Geffen School of Medicine, Los Angeles, CA.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Han
authors.forename: Michael R
authors.initials: MR
authors.lastname: Girvigian
authors.forename: Joseph C T
authors.initials: JC
authors.lastname: Chen
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Miller
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lodin
authors.forename: Javad
authors.initials: J
authors.lastname: Rahimian
authors.forename: Alonzo
authors.initials: A
authors.lastname: Arellano
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Cahan
authors.forename: John S
authors.initials: JS
authors.lastname: Kaptein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000532:radiotherapy; D016634:Radiosurgery / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D016879:Salvage Therapy; D019292:Skull Base Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome; D047368:Tumor Burden