Abstract
BACKGROUND
Meningioma is the most common benign adult primary intracranial tumor. A proportion of these patients are not candidates for surgical management, or reject invasive procedures, in these scenarios stereotactic radiosurgery is a feasible option, with excellent local control and minimal adverse events.
AIM
•Determine radiological tumor response in patients treated with radiosurgery with radical or adjuvant intent.
•Describe toxicity and symptom control.
METHODS
From September 2012 to June 2015, 127 patients, 99 female, 28 men, with a median age 55 years, affected by intracranial meningiomas, were treated with Cyberknife system in our Radiation Oncology department.
RESULTS
Local control was analyzed using serial images and clinical outcomes. Median follow up was 35 months. Patients’ characteristics are shown in Table 1.
The intention of treatment was: 33.9% as adjuvant treatment after surgery, 10.2% for recurrent tumors and 55.9% of patients were treated with radical intent. 52.8% were treated with 14 Gy in a single fraction SRS and 47.2% with fractionated stereotactic radiosurgery to a total of 25 Gy. Median volume was 3.71 mm3 for single fraction and 7.6 mm3 for fractionated treatment.
Treatment dosimetry characteristics are shown in table 2.
Local control was achieved in 93.7% with 4.7% progression.
Toxicity was present in 22% of the single fraction group and in 30% of the fractionated group. Necrosis was intratumoral. in all cases
Symptoms control was achieved in 89% of the study population.
Progression-free survival (PFS) was 72.8 months (95% confidence interval (CI) 68.5-77) Figure 1.
CONCLUSION
Stereotactic radiosurgery and fractionated stereotactic radiotherapy with Cyberknife is safe and effective against small intracranial meningiomas. With more than 90% local control, and a PFS rate equivalent to recent treatments.
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