Skip to main content
SpringerLink
Log in

Efficacy of postoperative radiotherapy for high grade meningiomas

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

The necessity of postoperative radiotherapy (PORT) for meningiomas remains contentious. Here, the role of PORT in patients who underwent surgical resection for WHO grade II and III meningiomas was assessed. The record of 114 patients with WHO grade II (n = 72) and III (n = 42) meningiomas treated at Samsung Medical Center between March 1995 and April 2013 were reviewed and classified according to the extent of surgical resection and implementation of PORT. Median follow-up was 55.9 months. Simpson grade (SG) I, II, III, and IV resections were achieved in 29, 56, 9 and 20 patients, respectively. The 5-year local control (LC) and overall survival rate was 65.8 and 84.2 %, respectively. Thirty patients (26.3 %) developed local failure and five patients (4.4 %) developed distant metastases. The extent of surgical resection (SG I–II vs. III–IV) was influenced by tumor location (orbital and skull base lesions vs. others, p = 0.001) and the surgeons’ experience (>10 operations, p = 0.044). Extent of surgical resection was also associated with local failure, overall progression, and overall survival (p = 0.001, p < 0.001, and p < 0.001, respectively). PORT improved LC in patients with incomplete surgical resection (SG III–IV, p = 0.049). Complete resection (SG I–II) is an important prognostic factor for LC and survival, and the extent of surgical resection (SG I–II vs. III–IV) is influenced by tumor location. PORT could improve the LC in WHO grade II–III meningioma patients who underwent incomplete surgical resection (SG III–IV).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Marta GN, Correa SF, Teixeira MJ (2011) Meningioma: review of the literature with emphasis on the approach to radiotherapy. Expert Rev Anticancer Ther 11(11):1749–1758. doi:10.1586/era.11.162

    Article  PubMed  Google Scholar 

  2. Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW (2008) Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. J Neurol Neurosurg Psychiatry 79(5):574–580. doi:10.1136/jnnp.2007.121582

    Article  PubMed  Google Scholar 

  3. Perry A, Stafford SL, Scheithauer BW, Suman VJ, Lohse CM (1997) Meningioma grading: an analysis of histologic parameters. Am J Surg Pathol 21(12):1455–1465

    Article  CAS  PubMed  Google Scholar 

  4. Glaholm J, Bloom HJ, Crow JH (1990) The role of radiotherapy in the management of intracranial meningiomas: the Royal Marsden Hospital experience with 186 patients. Int J Radiat Oncol Biol Phys 18(4):755–761

    Article  CAS  PubMed  Google Scholar 

  5. Oya S, Kawai K, Nakatomi H, Saito N (2012) Significance of Simpson grading system in modern meningioma surgery: integration of the grade with MIB-1 labeling index as a key to predict the recurrence of WHO Grade I meningiomas. J Neurosurg 117(1):121–128. doi:10.3171/2012.3.jns111945

    Article  PubMed  Google Scholar 

  6. Johnson J, Barani IJ (2013) Radiotherapy for malignant tumors of the skull base. Neurosurg Clin N Am 24(1):125–135. doi:10.1016/j.nec.2012.08.011

    Article  PubMed  Google Scholar 

  7. Paulsen F, Doerr S, Wilhelm H, Becker G, Bamberg M, Classen J (2012) Fractionated stereotactic radiotherapy in patients with optic nerve sheath meningioma. Int J Radiat Oncol Biol Phys 82(2):773–778. doi:10.1016/j.ijrobp.2010.11.018

    Article  PubMed  Google Scholar 

  8. Goldsmith BJ, Wara WM, Wilson CB, Larson DA (1994) Postoperative irradiation for subtotally resected meningiomas: A retrospective analysis of 140 patients treated from, 1967 to 1990. J Neurosurg 80(2):195–201. doi:10.3171/jns.1994.80.2.0195

    Article  CAS  PubMed  Google Scholar 

  9. Marcus HJ, Price SJ, Wilby M, Santarius T, Kirollos RW (2008) Radiotherapy as an adjuvant in the management of intracranial meningiomas: are we practising evidence-based medicine? Br J Neurosurg 22(4):520–528. doi:10.1080/02688690802308687

    Article  CAS  PubMed  Google Scholar 

  10. Aghi MK, Carter BS, Cosgrove GR, Ojemann RG, Amin-Hanjani S, Martuza RL, Curry WT Jr, Barker FG 2nd (2009) Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation. Neurosurgery 64(1):56–60. doi:10.1227/01.NEU.0000330399.55586.63 discussion 60

    Article  PubMed  Google Scholar 

  11. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114(2):97–109. doi:10.1007/s00401-007-0243-4

    Article  PubMed Central  PubMed  Google Scholar 

  12. Maclean J, Fersht N, Short S (2014) Controversies in radiotherapy for meningioma. Clin Oncol 26(1):51–64. doi:10.1016/j.clon.2013.10.001

    Article  CAS  Google Scholar 

  13. Coke CC, Corn BW, Werner-Wasik M, Xie Y, Curran WJ Jr (1998) Atypical and malignant meningiomas: an outcome report of seventeen cases. J Neurooncol 39(1):65–70

    Article  CAS  PubMed  Google Scholar 

  14. Park HJ, Kang HC, Kim IH, Park SH, Kim DG, Park CK, Paek SH, Jung HW (2013) The role of adjuvant radiotherapy in atypical meningioma. J Neurooncol 115(2):241–247. doi:10.1007/s11060-013-1219-y

    Article  CAS  PubMed  Google Scholar 

  15. Jo K, Park HJ, Nam DH, Lee JI, Kong DS, Park K, Kim JH (2010) Treatment of atypical meningioma. J Clin Neurosci 17(11):1362–1366. doi:10.1016/j.jocn.2010.03.036

    Article  PubMed  Google Scholar 

  16. Rosenberg LA, Prayson RA, Lee J, Reddy C, Chao ST, Barnett GH, Vogelbaum MA, Suh JH (2009) Long-term experience with World Health Organization grade III (malignant) meningiomas at a single institution. Int J Radiat Oncol Biol Phys 74(2):427–432. doi:10.1016/j.ijrobp.2008.08.018

    Article  PubMed  Google Scholar 

  17. Mair R, Morris K, Scott I, Carroll TA (2011) Radiotherapy for atypical meningiomas. J Neurosurg 115(4):811–819. doi:10.3171/2011.5.jns11112

    Article  PubMed  Google Scholar 

  18. Vogelbaum MA, Leland Rogers C, Linskey MA, Mehta MP (2010) Opportunities for clinical research in meningioma. J Neurooncol 99(3):417–422. doi:10.1007/s11060-010-0375-6

    Article  PubMed  Google Scholar 

  19. Coskun M, Straube W, Hurkmans CW, Melidis C, de Haan PF, Villa S, Collette S, Weber DC (2013) Quality assurance of radiotherapy in the ongoing EORTC 22042-26042 trial for atypical and malignant meningioma: results from the dummy runs and prospective individual case Reviews. Radiat Oncol (London, England) 8:23. doi:10.1186/1748-717x-8-23

    Article  Google Scholar 

  20. Walcott BP, Nahed BV, Brastianos PK, Loeffler JS (2013) Radiation treatment for WHO Grade II and III meningiomas. Front Oncol 3:227. doi:10.3389/fonc.2013.00227

    PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Yunseon Choi & Do Hoon Lim

  2. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Kyungil Jo, Do-Hyun Nam, Ho Jun Seol & Jung-Il Lee

Authors
  1. Yunseon Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Do Hoon Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kyungil Jo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Do-Hyun Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ho Jun Seol
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jung-Il Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Do Hoon Lim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choi, Y., Lim, D.H., Jo, K. et al. Efficacy of postoperative radiotherapy for high grade meningiomas. J Neurooncol 119, 405–412 (2014). https://doi.org/10.1007/s11060-014-1507-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-014-1507-1

Keywords

Search

Navigation