The role of single-fraction stereotactic radiosurgery for atypical meningiomas (WHO grade II): treatment results based on a 25-year experience

• Published in: Journal of neuro-oncology 2021-12, Vol.155 (3), p.335-342
• Main Authors: Hasegawa, Hirotaka, Vakharia, Kunal, Link, Michael J., Stafford, Scott L., Brown, Paul D., Parney, Ian F., Burns, Terry C., Yan, Elizabeth S., Mahajan, Anita, Laack, Nadia N., Pollock, Bruce E.
• Format: Article
• Language: English
• Subjects: Brain cancer; Clinical Study; Follow-Up Studies; Humans; Medicine; Medicine & Public Health; Meningeal Neoplasms - radiotherapy; Meningeal Neoplasms - surgery; Meningioma - radiotherapy; Meningioma - surgery; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - radiotherapy; Neoplasm Recurrence, Local - surgery; Neurology; Oncology; Patients; Radiation; Radiation therapy; Radiosurgery; Radiosurgery - adverse effects; Retrospective Studies; Seizures; Treatment Outcome; Tumors; World Health Organization
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-021-03882-9

Purpose To clarify the role of stereotactic radiosurgery (SRS) for atypical meningiomas (AM). Methods A retrospective analysis of 68 patients with AM having SRS from 1995 until 2019. Results Nineteen patients (28%) had undergone prior external beam radiation therapy (EBRT) (median dose, 54 Gy). The median follow-up period was 52 months. Eighteen (26%), 17 (25%), and 33 (49%) patients received SRS as an upfront adjuvant (≤ 6 months), early salvage (7–18 months), or late salvage treatment (> 18 months), respectively. The 3-, 5-, and 10-year progression-free survivals (PFSs) were 52%, 35%, and 25%, respectively. The 3-, 5-, and 10-year disease-specific survivals were 85%, 78%, and 61%, respectively. Adverse radiation events (AREs) were observed in 12 patients (18%), with increased or new seizures being the most frequent complication (n = 7). Prior EBRT was associated with reduced PFS (HR 5.92, P