Clinical outcome after high-precision radiotherapy for skull base meningiomas: pooled data from three large German centers for radiation oncology

Purpose - To evaluate outcome in patients with base of skull meningiomas treated with modern high precision radiation therapy (RT) techniques. - Patients and methods - 927 patients from three centers were treated with either radiosurgery or fractionated high-precision RT for meningiomas. Treatment p...

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Main Authors: Combs, Stephanie (Author) , Debus, Jürgen (Author)
Format: Article (Journal)
Language:English
Published: [May 2018]
In: Radiotherapy and oncology
Year: 2018, Volume: 127, Issue: 2, Pages: 274-279
ISSN:1879-0887
DOI:10.1016/j.radonc.2018.03.006
Online Access:Verlag, Volltext: https://doi.org/10.1016/j.radonc.2018.03.006
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0167814018301385
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Author Notes:Stephanie E. Combs, Mostafa Farzin, Julia Boehmer, Oliver Oehlke, Michael Molls, Jürgen Debus, Anca-Ligia Grosu

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520 |a Purpose - To evaluate outcome in patients with base of skull meningiomas treated with modern high precision radiation therapy (RT) techniques. - Patients and methods - 927 patients from three centers were treated with either radiosurgery or fractionated high-precision RT for meningiomas. Treatment planning was based on CT and MRI following institutional guidelines. For radiosurgery, a median dose of 13Gy was applied, for fractionated treatments, a median dose of 54Gy in 1.8Gy single fractions was prescribed. Follow-up included a clinical examination as well as contrast-enhanced imaging. All patients were followed up prospectively after radiotherapy in the three departments within a strict follow-up regimen. The median follow-up time was 81months (range 1-348months). - Results - Median local control was 79months (range 1-348months). Local control (LC) was 98% at 1year, 94% at 3years, 92% at 5years and 86% at 10years. There was no difference between radiosurgery and fractionated RT. We analyzed the influence of higher doses on LC and could show that dose did not impact LC. Moreover, there was no difference between 54Gy and 57.6Gy in the fractionated group. Side effects were below 5% in both groups without any severe treatment-related complications. - Discussion - Based on the pooled data analysis this manuscript provides a large series of meningiomas of the skull base treated with modern high precision RT demonstrating excellent local control and low rates of side effects. Such data support the recommendation of RT for skull base meningiomas in the interdisciplinary tumor board discussions. The strong role of RT must influence treatment recommendations keeping in mind the individual risk-benefit profile of treatment alternatives. 
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