Summary
Thirty-six patients with benign meningioma were treated for primary or recurrent disease by subtotal resection and external beam irradiation from 1968–1986 at Massachusetts General Hospital. Comparison is made with 79 patients treated by subtotal surgery alone from 1962–1980.
Progression-free survival for 17 patients irradiated after initial incomplete surgeery was 88% at 8 years compared with 48% for similar patients treated by surgery alone (p = 0.057). 16 patients incompletely resected at time of first recurrence were irradiated and 78% were progression-free at 8 years while 11% of a similar group treated by surgery alone were progression free (p = 0.001). Long term overall survival was high and similar in both control and study groups. Two patients were irradiated at second recurrence and 1 patient at third recurrence.
Twenty-five patients were treated with photons alone and have a median follow-up of 57 months, 6 patients have recurred at doses 45-60 Gy. Eleven patients were treated with combined 10 MV photons and 160 MV protons utilizing 3-D treatment planning. These patients have been followed for a median of 53 months and none have failed to date. Eight of 11 received 54-60.4 Gy and 3/11 > 64.48 Gy. Sex, age, pathology grade and score, surgery and timing of radiation therapy were not associated with significant differences in failure patterns within the irradiated study group (p < 0.1). Complications have been seen in 6 irradiated patients.
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References
Chan RC, Thompson GB: Morbidity, mortality and quality of life following surgery for intracranial meningiomas. A retrospective study in 257 cases. J Neurosurg 60: 52–60, 1984
Jaaskelainen J, Haita M, Servo A: Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol 25: 233–242, 1986
Marks SM, Whitwell HL, Lye RH: Recurrence of meningiomas after operation. Surg Neurol 25: 436–440, 1986
Yamashita J, Handa H, Iwaki K, Abe M: Recurrence of intracranial meningiomas with special reference of radiotherapy. Surg Neurol 14: 33–40, 1980
Adegbite AB, Khan MI, Paine KWE, Tan LK: The recurrence of intracranial meningiomas after surgical treatment. J Neurosurg 58: 51–56, 1983
Barbaro NM, Gutin PH, Wilson CB, Sheline GE, Boldrey EB, Wara WM: Radiation therapy in the treatments of partially resected meningiomas. Neurosurgery 204: 525–528, 1987
Bloom HCJ: Intracranial tumors: response and resistance to therapeutic endeavors, 1970–1980. Int J Rad Oncol Biol Phys 8: 1083–1113, 1982
Carella RJ, Ransohoff J, Newall J: Role of radiation therapy in the management of meningioma. Neurosurgery 103: 332–339, 1982
Forbes AR, Goldberg ID: Radiation therapy in the treatment of meningioma: The Joint Center for Radiation Therapy experience 1970–1982. J Clin Oncol 210: 1139–1143, 1984
Friedman M: Irradiation of meningioma: a prototype circumscribed tumor for planning high-dose irradiation of the brain. Int J Rad Oncol Biol Phys 2: 949–958, 1977
Petty AM, Kun LE, Meyer GA: Radiation therapy for incompletely resected meningiomas. J Neurosurg 62: 502–507, 1986
Solan JM, Kramer S: The role of radiation therapy in the management of intracranial meningiomas. Int J Rad Oncol Biol Phys 11: 675–677, 1985
Taylor BW, Marcus RB, Friedman WA, Ballinger WE, Million RE: Int J Rad Oncol Biol Phys 15: 200–304, 1988
Wara WM, Sheline GE, Newman H, Townsend JJ, Boldrey RB: Radiation therapy of meningiomas. Am J Roentgenol 123(3): 453–458, 1975
Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RJ, Martuza RL: Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62: 18–24, 1985
Monte de la SM, Flickinger J, Linggood RM: Histopathologic features predicting recurrence of meningiomas following subtotal resection. Am J Surg Pathol 10(12): 836–843, 1986
SAS Institute Inc. SAS User's Guide: Statistics, Version 5 Edition. Cary, NC: SAS Institute Inc. 1985, 956 pp
Guidetti B, Ciappeta P, Domenicucci M: Tentorial meningiomas: surgical experience with 61 cases and long-term results. J Neurosurg 69: 183–187, 1988
Salazar OM: Ensuring local control in meningiomas. Int J Rad Oncol Biol Phys 15: 501–104, 1988
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Miralbell, R., Linggood, R.M., de la Monte, S. et al. The role of radiotherapy in the treatment of subtotally resected benign meningiomas. J Neuro-Oncol 13, 157–164 (1992). https://doi.org/10.1007/BF00172765
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DOI: https://doi.org/10.1007/BF00172765