Functional outcome of patients with benign meningioma treated by 3D conformal irradiation with a combination of photons and protons

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• 作者：Georges Noë ; l ; Marc A. Bollet ; Valentin Calugaru ; Loï ; c Feuvret ; Christine Haie-Meder ; Fré ; dé ; ric Dhermain ; Ré ; gis Ferrand ; Gilbert Boisserie ; Anne Beaudré ; Jean-Jacques Mazer
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2005
• 期刊代码：136_03603016
• 类别：med
• 出版时间：2005
• 卷：62
• 期：5
• 页码：1412-1422
• 文件大小：487 K

摘要

Purpose: To evaluate efficacy and tolerance of external fractionated combination of photon and proton radiation therapy (RT) for intracranial benign meningiomas.

Methods and Materials: Between 1994 and 2002, 51 patients with intracranial meningiomas of the base of the skull were treated with a combination of photon and proton RT. Median total dose was 60.6 cobalt Gy equivalent (54–64).

One hundred eight eye-related symptoms were collected; 80 other symptoms were noted and followed up.

Results: Mean follow-up was 25.4 months. Acute tolerance was excellent. Out of the 108 eye-related symptoms, 106 (96%) were evaluated. Improvements were reported for 73 (68.8%) of them. Out of the 88 other miscellaneous symptoms, 81 (92%) were evaluated. Improvements were reported in 54 cases (67%). Median time to improvement ranged from 1 to 24 months after completion of the radiotherapy, depending on the symptom. We did not observe any worsening of primary clinical signs. Radiologically, 1 patient relapsed 4 months after the end of irradiation. Pathology revealed a malignant (Grade 3) transformation of the initial Grade 1 meningioma. Four-year local control and overall survival rates were, respectively, 98%and 100%. Stabilization of the tumor was observed in 38 cases (72%), volume reduction in 10 cases (20%), and intratumor necrosis in 3 cases. Two patients complained of Grade 3 side effects: 1 unilateral hearing loss requiring aid and 1 case of complete pituitary deficiency.

Conclusion: These results stressed the clinical efficacy of fractionated-associated photon-proton RT in the treatment of meningiomas, especially on cranial nerve palsies, without severe toxicity in almost all patients.