Long-term outcome of moderate hypofractionated stereotactic radiotherapy for meningiomas.
OBJECTIVE
The aim of this work was to evaluate long-term results of moderate hypofractionated stereotactic radiotherapy (hFSRT) for intracranial meningiomas.


METHODS
In all, 77 consecutive patients with 80 lesions were included. Median age was 65 years (range 23-82 years), male/female ratio was 21/56, and the median Karnofsky performance status was 90 (range 60-100). In 31 lesions (39 %), diagnosis was based upon clinical and radiological data; 37 lesions were histologically proven as World Health Organization (WHO) grade I and 12 grade II meningiomas. Median treatment volume was 23 cc. Prescribed doses were 45 Gy in 15 fractions of 3 Gy (15 × 3 Gy) or 42 Gy in 14 fractions of 3 Gy (14 × 3 Gy).


RESULTS
After a median follow-up of 56 months, 49 (61 %) lesions received 14 × 3 Gy and 31 (39 %) 15 × 3 Gy. Local control (LC) rate remained unchanged at 84 % at 5 and 10 years. Overall survival and disease-specific survival (DSS) were 76 and 93 % at 5 years, 72 and 89 % at 10 years, respectively. With univariate analysis, previous surgery and WHO grade II tumor were negative prognostic factors for LC and DSS. With multivariate analysis only tumor grade was an independent prognostic factor for LC. No clinically significant acute and/or late toxicities were observed.


CONCLUSIONS
Moderate hFSRT was effective and safe with an excellent tolerance profile. It can be an alternative treatment option for patients with recurrent or inoperable large meningiomas. The low number of fractions administered with hFSRT led to reduce treatment-related discomfort for patients. Grade II tumor and previous surgery were negative prognosis factors.
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy. e.maranzano@aospterni.it.
Ernesto
E
Maranzano
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy.
Lorena
L
Draghini
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy.
Michelina
M
Casale
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy.
Fabio
F
Arcidiacono
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy.
Paola
P
Anselmo
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy.
Fabio
F
Trippa
Radiotherapy Oncology Centre, "S. Maria" Hospital, Via T. di Joannuccio, 1, 05100, Terni, Italy.
Cesare
C
Giorgi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D000069473:Radiation Dose Hypofractionation; D016634:Radiosurgery / Q000379:methods*
Hypofractionated radiotherapy; Neoplasms, nerve tissue; Prognosis; Stereotactic radiotherapy; Survival