CyberKnife multisession stereotactic radiosurgery and hypofractionated stereotactic radiotherapy for perioptic meningiomas: intermediate-term results and radiobiological considerations

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• 作者：Alfredo Conti ; Antonio Pontoriero ; Federica Midili ; Giuseppe Iat矛…
• 关键词：Meningioma ; CyberKnife ; Radiation induced optic neuropathy ; Hypofractionated stereotactic radiotherapy ; Radiobiology
• 刊名：SpringerPlus
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：4
• 期：1
• 全文大小：1648KB
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• 作者单位：Alfredo Conti (1)
  Antonio Pontoriero (2)
  Federica Midili (3)
  Giuseppe Iat矛 (2)
  Carmelo Siragusa (3)
  Chiara Tomasello (4)
  Domenico La Torre (1)
  Salvatore M Cardali (1)
  Stefano Pergolizzi (2)
  Costantino De Renzis (2)
  
  1. Department of Neurosurgery, University of Messina, AOU 鈥淧oliclinico G. Martino鈥? Via Consolare Valeria 1, 98125, Messina, Italy
  2. Department of Radiation Oncology, University of Messina, AOU 鈥淧oliclinico G. Martino鈥? Via Consolare Valeria 1, 98125, Messina, Italy
  3. Department of Medical Physics, University of Messina, AOU 鈥淧oliclinico G. Martino鈥? Via Consolare Valeria 1, 98125, Messina, Italy
  4. Department of Oncology, University of Messina, AOU 鈥淧oliclinico G. Martino鈥? Via Consolare Valeria 1, 98125, Messina, Italy
  
• 刊物类别：Science, general;
• 刊物主题：Science, general;
• 出版者：Springer International Publishing
• ISSN：2193-1801

文摘

Single fraction radiosurgery is conventionally precluded for lesions lying <2-3 mm of the anterior visual pathway because of the radiosensitivity of the optic nerve. We analyzed a series of 64 patients with 鈥減erioptic鈥?meningiomas treated by CyberKnife multisession radiosurgery and hypofractionated stereotactic radiotherapy (hSRT). Between July 2007-May 2010, patients were treated using conventional multisession Cyberknife schemes (2鈥? fractions) and results were retrospectively analyzed. A radiobiological model was then developed to estimate the best tumor control probability (TCP)/ normal tissue complication probability (NTCP) for these lesions. Resulting dose/fraction schemes were applied to patients treated between May 2010 and July 2014. Data were prospectively collected Twenty-five patients were included in the retrospective part of the study. Median tumor volume was 4.95 cc; median dose was 23.0 Gy and median number of fraction was 5 (range 2鈥?). No patient had visual deterioration at mean follow-up of 60鈥壜扁€?2 months. Tumor control was achieved in all cases. Thirty-nine patients were treated according the radiobiology model and results prospectively analyzed. Median tumor volume was 7.5 cc, median dose 25.0 Gy and mean number of fraction 5 (range 3鈥?5). No patient had visual deterioration or tumor progression at mean follow-up of 17鈥壜扁€?0 months. Conventional multisession CyberKnife treatments (2鈥? fractions) provided satisfactory results. Nonetheless, our estimation of TCP suggests the use of higher doses to grant long-term disease control. To achieve higher equivalent doses without significantly increasing the NTCP, we suggest the use of a greater number of fractions, moving to hSRT, in tumors in which the encasement of optic nerves is presumed. Keywords Meningioma CyberKnife Radiation induced optic neuropathy Hypofractionated stereotactic radiotherapy Radiobiology