Meningioma of the skull base: long-term outcome after image-guided stereotactic radiotherapy.


PURPOSE The purpose of this study was to analyse the feasibility, safety, and long-term efficacy of linear accelerator-based fractionated stereotactic radiotherapy for meningiomas of the skull base. We evaluated the long-term clinical outcome of patients and identified prognostic factors after fractionated stereotactic radiotherapy. PATIENTS AND METHODS Between 10/1995 and 03/2009, 136 patients with a median age of 57 years with skull base meningioma received fractionated stereotactic radiotherapy. A total of 34 patients had a grade I meningioma, in 102 cases no histology was obtained (grade 0). Fractionated stereotactic radiotherapy was delivered as primary treatment for 57 patients and postoperatively for 79. The patients received a mean total dose of 56.95 (min/max 32.4/63)Gy. RESULTS Median follow-up was 44.9 months. Overall progression-free survival was 96.9% after 3 years, 93.8% after 5 years, and 91.5% after 10 years. Patients with unknown histology showed progression-free survival rates of 100%, 98.7%, and 93.5% at 3, 5, and 10 years and patients with biopsy-proven grade I meningioma showed rates of 100% after 3 years, 91.7% after 5 years and 85.9% after 10 years. Patients with adjuvant radiotherapy showed significantly worse progression-free survival rates than patients who had been treated with primary radiotherapy (P=0.043), progression-free survival rates were independent of tumour size. The most common acute grade I symptoms were headache, fatigue, and local alopecia. The most common chronic grade I symptoms were fatigue and headache. CONCLUSIONS This large study showed that fractionated stereotactic radiotherapy is an effective and safe treatment modality with high progression-free survival rates for intracranial meningioma. We identified "prior surgery" as significant poor prognostic factor.

DOI: 10.1016/j.canrad.2014.07.159

5 Figures and Tables

Citations per Year

826 Citations

Semantic Scholar estimates that this publication has 826 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Kaul2014MeningiomaOT, title={Meningioma of the skull base: long-term outcome after image-guided stereotactic radiotherapy.}, author={David Kaul and Volker Budach and Martin Misch and E. Wiener and Sebastian Exner and Harun Badakhshi}, journal={Cancer radiothérapie : journal de la Société française de radiothérapie oncologique}, year={2014}, volume={18 8}, pages={730-5} }