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Proton therapy for atypical meningiomas

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Abstract

We report clinical outcomes of proton therapy in patients with World Health Organization grade 2 (atypical) meningiomas. Between 2005 and 2013, 22 patients with atypical meningiomas were treated to a median dose of 63 Gy (RBE) using proton therapy, as an adjuvant therapy after surgery (n = 12) or for recurrence or progression of residual tumor (n = 10). Six patients had presumed radiation-induced meningiomas, but none had received prior radiotherapy for their meningioma. The median follow-up time after radiation was 39 months (range 7–104) and all patients remain alive at last follow-up. The 5-year estimate of local control was 71.1 % (95 % CI 49.3–92.9 %). The 5-year estimate of local control was 87.5 % following a radiation dose >60 Gy (RBE), compared to 50.0 % for ≤60 Gy (RBE) (p = 0.038). The 5-year estimate of neuraxis dissemination was 5 % (95 % CI 0–14.6 %) and 6.2 % (95 % CI 0–18.2 %) for metastases outside of the central nervous system. Radiation necrosis was observed in one patient with a history of prior cranial irradiation. Fractionated proton therapy was associated with favorable tumor control rates for grade 2 meningiomas. Prospective studies are needed to define the optimal radiation dose for high-grade meningiomas.

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Author information

Author notes

  1. Mark W. McDonald

    Present address: Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA

  2. Mark A. Henderson

    Present address: Department of Radiation Oncology, Bay Area Hospital, Coos Bay, OR, USA

Authors and Affiliations

  1. Department of Radiation Oncology, Indiana University School of Medicine, 535 Barnhill Dr RT041, Indianapolis, IN, 46202, USA

    Mark W. McDonald, David A. Plankenhorn, Kevin P. McMullen & Mark A. Henderson

  2. Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Mitesh V. Shah & Aaron A. Cohen-Gadol

  3. Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA

    Edward J. Dropcho

  4. Goodman Campbell Brain and Spine, Indianapolis, IN, USA

    Mitesh V. Shah & Aaron A. Cohen-Gadol

  5. Indiana University Health Proton Therapy Center, Bloomington, IN, USA

    Mark W. McDonald & Kevin P. McMullen

Authors
  1. Mark W. McDonald
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  2. David A. Plankenhorn
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Correspondence to Mark W. McDonald.

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McDonald, M.W., Plankenhorn, D.A., McMullen, K.P. et al. Proton therapy for atypical meningiomas. J Neurooncol 123, 123–128 (2015). https://doi.org/10.1007/s11060-015-1770-9

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  • DOI: https://doi.org/10.1007/s11060-015-1770-9

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