CyberKnife Stereotactic Radiosurgery for Atypical and Malignant Meningiomas.

CyberKnife Stereotactic Radiosurgery for Atypical and Malignant Meningiomas.

World Neurosurg. 2016 Apr 20;

Authors: Zhang M, Ho AL, D'Astous M, Pendharkar AV, Choi CY, Thompson PA, Tayag AT, Soltys SG, Gibbs IC, Chang SD

Abstract
OBJECTIVE: Recurrent WHO Grade II and III meningiomas have traditionally been treated by surgery alone, but early literature suggests that adjuvant stereotactic radiosurgery (SRS) may greatly improve outcomes. The authors sought to present the long-term tumor control and safety of a hypofractionated SRS regimen.
METHODS: We reviewed the prospectively collected information of 44 WHO Grade II and 9 WHO Grade III meningiomas treated by CyberKnife for adjuvant or salvage therapy. Patient demographics, treatment parameters, local control, regional control, locoregional control, overall survival, radiation history, and complications were documented.
RESULTS: For WHO Grade II patients, recurrence occurred in 41%, with local, regional, and locoregional failure at 60 months recorded as 49%, 58% and 36%, respectively. For WHO Grade III patients, recurrence occurred in 66%, with local, regional, and locoregional failure at 12 months recorded as 57%, 100%, and 43%. The 60-month locoregional control rates for radiation naïve and experienced patients were 48% and 0% (p = 0.14), respectively. Overall, 7 of 44 Grade II patients and 8 of 9 Grade III patients had died at last follow-up. The 60-month and 12-month overall survival rates for Grade II and III meningioma were 87% and 50%, respectively. Serious complications occurred in 7.5% of patients.
CONCLUSIONS: SRS for adjuvant and salvage treatment of WHO Grade II meningioma by a hypofractionated plan is a viable treatment strategy with acceptable long-term tumor control, overall survival, and complication rates. Future work should contribute additional study toward the radiation naïve and the local management of malignant meningioma.

PMID: 27108030 [PubMed - as supplied by publisher]

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