Hypofractionated stereotactic radiotherapy (HFSRT) for who grade I anterior clinoid meningiomas (ACM)

Jpn J Radiol. 2016 Nov;34(11):730-737. doi: 10.1007/s11604-016-0581-z. Epub 2016 Sep 22.

Abstract

Purpose: While microsurgical resection plays a central role in the management of ACMs, extensive surgery may be associated with substantial morbidity particularly for tumors in intimate association with critical structures. In this study, we evaluated the use of HFSRT in the management of ACM.

Materials and methods: A total of 22 patients with ACM were treated using HFSRT. Frameless image guided volumetric modulated arc therapy (VMAT) was performed with a 6 MV linear accelerator (LINAC). The total dose was 25 Gy delivered in five fractions over five consecutive treatment days. Local control (LC) and progression free survival (PFS) rates were calculated using the Kaplan-Meier method. Common Terminology Criteria for Adverse Events, version 4.0 was used in toxicity grading.

Results: Out of the total 22 patients, outcomes of 19 patients with at least 36 months of periodic follow-up were assessed. Median patient age was 40 years old (range 24-77 years old). Median follow-up time was 53 months (range 36-63 months). LC and PFS rates were 100 and 89.4 % at 1 and 3 years, respectively. Only two patients (10.5 %) experienced clinical deterioration during the follow-up period.

Conclusion: LINAC-based HFSRT offers high rates of LC and PFS for patients with ACMs.

Keywords: Anterior clinoid meningiomas (ACM); Hypofractionated stereotactic radiotherapy (HFSRT); Linear accelerator (LINAC).

MeSH terms

  • Adult
  • Aged
  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy*
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Male
  • Meningioma / pathology
  • Meningioma / radiotherapy*
  • Middle Aged
  • Neoplasm Grading
  • Particle Accelerators
  • Radiotherapy, Intensity-Modulated / instrumentation
  • Radiotherapy, Intensity-Modulated / methods*
  • Treatment Outcome