title: Brachytherapy in the treatment of recurrent aggressive falcine meningiomas.
abstract: Recurrent aggressive falcine meningiomas are uncommon tumors that recur despite receiving extensive surgery and radiation therapy (RT). We have utilized brachytherapy as a salvage treatment in two such patients with a unique implantation technique. Both patients had recurrence of WHO Grade II falcine meningiomas despite multiple prior surgical and RT treatments. Radioactive I-125 seeds were made into strands and sutured into a mesh implant, with 1 cm spacing, in a size appropriate to cover the cavity and region of susceptible falcine dura. Following resection the vicryl mesh was implanted and fixed to the margins of the falx. Implantation in this interhemispheric space provides good dose conformality with targeting of at-risk tissue and minimal radiation exposure to normal neural tissues. The patients are recurrence free 31 and 10 months after brachytherapy treatment. Brachytherapy was an effective salvage treatment for the recurrent aggressive falcine meningiomas in our two patients.
authors.affiliation: College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors.forename: Hussam
authors.initials: H
authors.lastname: Abou Al-Shaar
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, and Children's Hospital, Harvard Medical School (HMS), 15 Francis Street, Boston, MA, 02115, USA.|Division of Neurological Surgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Kaith K
authors.initials: KK
authors.lastname: Almefty
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, and Children's Hospital, Harvard Medical School (HMS), 15 Francis Street, Boston, MA, 02115, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abolfotoh
authors.affiliation: Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA.
authors.forename: Nils D
authors.initials: ND
authors.lastname: Arvold
authors.affiliation: Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Devlin
authors.affiliation: Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Reardon
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Loeffler
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, and Children's Hospital, Harvard Medical School (HMS), 15 Francis Street, Boston, MA, 02115, USA. oalmefty@partners.org.
authors.forename: Ossama
authors.initials: O
authors.lastname: Al-Mefty
mesh_terms: D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000532:radiotherapy*; D008579:Meningioma / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D016896:Treatment Outcome
keywords: Atypical meningioma; Brachytherapy; Falcine; Falcine meningioma; I-125; Meningioma