Hypofractionated high-energy proton-beam irradiation is an alternative treatment for WHO grade I meningiomas

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Vlachogiannis, PavlosUppsala universitet,Neurokirurgi (författare)

Hypofractionated high-energy proton-beam irradiation is an alternative treatment for WHO grade I meningiomas

Artikel/kapitelEngelska2017

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2017-10-24
Springer Science and Business Media LLC,2017
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-342199
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-342199URI
https://doi.org/10.1007/s00701-017-3352-4DOI

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Språk:engelska
Sammanfattning på:engelska

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Radiation treatment is commonly employed in the treatment of meningiomas. The aim of this study was to evaluate the effectiveness and safety of hypofractionated high-energy proton therapy as adjuvant or primary treatment for WHO grade I meningiomas. A total of 170 patients who received irradiation with protons for grade I meningiomas between 1994 and 2007 were included in the study. The majority of the tumours were located at the skull base (n = 155). Eighty-four patients were treated post subtotal resection, 42 at tumour relapse and 44 with upfront radiotherapy after diagnosis based on the typical radiological image. Irradiation was given in a hypofractionated fashion (3-8 fractions, usually 5 or 6 Gy) with a mean dose of 21.9 Gy (range, 14-46 Gy). All patients were planned for follow-up with clinical controls and magnetic resonance imaging scans at 6 months and 1, 2, 3, 5, 7 and 10 years after treatment. The median follow-up time was 84 months. Age, gender, tumour location, Simpson resection grade and target volume were assessed as possible prognostic factors for post-irradiation tumour progression and radiation related complications. The actuarial 5- and 10-year progression-free survival rates were 93% and 85% respectively. Overall mortality rate was 13.5%, while disease-specific mortality was 1.7% (3/170 patients). Older patients and patients with tumours located in the middle cranial fossa had a lower risk for tumour progression. Radiation-related complications were seen in 16 patients (9.4%), with pituitary insufficiency being the most common. Tumour location in the anterior cranial fossa was the only factor that significantly increased the risk of complications. Hypofractionated proton-beam radiation therapy may be used particularly in the treatment of larger World Health Organisation grade I meningiomas not amenable to total surgical resection. Treatment is associated with high rates of long-term tumour growth control and acceptable risk for complications.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng
Meningioma
Benign meningioma
Proton beam irradiation
Hypofractionation

Biuppslag (personer, institutioner, konferenser, titlar ...)

Gudjonsson, OlafurUppsala universitet,Neurokirurgi(Swepub:uu)olafgudj (författare)
Montelius, AndersUppsala universitet,Medicinsk strålningsvetenskap(Swepub:uu)andemont (författare)
Grusell, ErikUppsala universitet,Medicinsk strålningsvetenskap(Swepub:uu)erikgrus (författare)
Isacsson, UlfUppsala universitet,Medicinsk strålningsvetenskap(Swepub:uu)ulfisacs (författare)
Nilsson, Kristina,1967-Uppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)kristnil (författare)
Blomquist, ErikUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)erikblom (författare)
Uppsala universitetNeurokirurgi (creator_code:org_t)

Sammanhörande titlar

Ingår i:Acta Neurochirurgica: Springer Science and Business Media LLC159:12, s. 2391-24000001-62680942-0940

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Av författaren/redakt...: Vlachogiannis, P ...; Gudjonsson, Olaf ...; Montelius, Ander ...; Grusell, Erik; Isacsson, Ulf; Nilsson, Kristin ...; visa fler...; Blomquist, Erik; visa färre...

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