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A Journal on Neurosurgery

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Journal of Neurosurgical Sciences 2009 March;53(1):7-11

language: English

Hypofractionated stereotactic radiotherapy for intracranial meningiomas: preliminary results of a feasible trial

Trippa F., Maranzano E., Costantini S., Giorni C.

Radiation Oncology Centre “S. Maria” Hospital, Terni, Italy


Aim. Fractionated stereotactic radiotherapy is an alternative to radiosurgery or conformal radiotherapy when meningiomas are surgically inaccessible, incompletely removed, or recurrent. The authors report preliminary results of a feasible trial on hypofractionated stereotactic radiotherapy (hFSRT) in patients (pts) with intracranial meningiomas.
Methods. From August 2003 to May 2007, 35 consecutive pts with a median age of 59 years (range, 23-86) underwent hFSRT for intracranial meningiomas. Male/female ratio was 9/26, median Karnofsky performance status was 90 (range, 60-100). In 14 lesions (40%) diagnosis was based upon clinical and radiological data. After surgery or biopsy, 19 pts had histologically proven World Health Organization grade I and 2 pts grade II meningiomas. The median treatment volume was 23 cc (range, 4-58 cc). Before hFSRT, 26 (74%) pts had neurologic symptoms. Nineteen (54%) pts received 42 Gy and 16 (46%) 45 Gy of total dose, 3 Gy/fraction, 5 fractions/week.
Results. The median follow-up was 29 months (range, 10-51) and 22 (63%) pts had a follow-up ≥24 months. Treatment was well tolerated and we did not observe clinically significant acute and late toxicity. At instrumental control, 32 (91%) lesions remained stable, 2 (6%) decreased and 1 (3%) progressed in size. Median duration of local control was 24 months (range, 4-47), and median progression free survival 23 months (range, 4-47). Clinical improvement of pre-existing neurological symptoms was observed in 84% of cases.
Conclusion. These preliminary data suggest that hFSRT is a safe and effective treatment modality for intracranial meningiomas.

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