title: Earlier and sustained response with incidental use of cardiovascular drugs among patients with low- to medium-grade meningiomas treated with radiosurgery (SRS) or stereotactic radiotherapy (SRT).
abstract: OBJECTIVE
  Beneficial outcome for cancer treated with radiotherapy (RT) and β-blockers has been reported. We hypothesize a potential combined impact of stereotactic RT with incidental use of cardiovascular drugs also in meningiomas.
  
  
  METHODS
  In 64 patients with 70 intracranial meningiomas (male/female=17/53; median follow-up=2 years) from a prospective database with sustained RT/cardiovascular drug therapy tumor response (progression, stable disease, regression) was evaluated at predefined follow-up intervals of 3, 12 and 24 months based on MR-imaging. For this retrospective cohort analysis stepwise univariate and multivariate analyses for group comparison were performed. Between groups analysis and stepwise uni- and multivariate analysis was performed.
  
  
  RESULTS
  At one year follow-up there was a significant better tumor response for patients with antihypertensives use (p=0.008) and radiosurgery (SRS) (p=0.054), the difference between patients with and without antihypertensive medication remains significant in multivariate analysis. Two years after RT, only patients with β-blocker use had a significant better response to RT (p=0.032). Additionally, for the use of β-blockers a trend toward significance for early tumor response at 3 months compared to the control group was observed (p(one tailed)=0.059).
  
  
  CONCLUSIONS
  Our data suggest that concomitant antihypertensive medication (especially β-blockers) may lead to an earlier and sustained response in stereotactic irradiated low- to medium-grade intracranial meningiomas by affecting the β-adrenergic pathways.
authors.affiliation: Department of Neurosurgery, University of Bonn Medical Center, Germany.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Pintea
authors.affiliation: Department of Neurosurgery, University of Bonn Medical Center, Germany.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kinfe
authors.affiliation: Department of Radiosurgery and Stereotactic Radiotherapy, MediClin Robert Janker Clinic, Bonn, Germany; Clinical Cooperation Unit Neurooncology, MediClin Robert Janker Clinic & University of Bonn Medical Center, Germany.
authors.forename: Brigitta G
authors.initials: BG
authors.lastname: Baumert
authors.affiliation: Department of Neurosurgery, University of Bonn Medical Center, Germany; Department of Radiosurgery and Stereotactic Radiotherapy, MediClin Robert Janker Clinic, Bonn, Germany; Clinical Cooperation Unit Neurooncology, MediClin Robert Janker Clinic & University of Bonn Medical Center, Germany. Electronic address: Jan.Bostroem@ukb.uni-bonn.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Boström
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D013566:Sympathomimetics / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002317:Cardiovascular Agents; D013566:Sympathomimetics
keywords: Beta-blocker; Meningioma; Radiation therapy; Radiosurgery