Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Sep;19(9):1261-4.
doi: 10.1016/j.jocn.2012.01.023. Epub 2012 Jul 10.

Reirradiation of recurrent meningioma

Andrzej P Wojcieszynski  1 , Nitin Ohri, David W Andrews, James J Evans, Adam P Dicker, Maria Werner-Wasik
Affiliations

Reirradiation of recurrent meningioma

Andrzej P Wojcieszynski et al. J Clin Neurosci. 2012 Sep.

Abstract

Management of meningioma includes observation, resection, and radiation therapy (RT). For patients with recurrent disease, similar options exist. However, the control rate following a second course of RT for recurrent disease is unknown. We reviewed an institutional database of patients with meningioma treated with stereotactic radiosurgery or fractionated stereotactic RT who underwent a second course for recurrent disease. Cox regression model was used for analysis. Variables tested included tumor volume, RT type, tumor grade, age at diagnosis, time to progression, and interval between RT. Eleven of 19 patients (58%) experienced disease progression. Median time to second progression was 10 months. Freedom from progression at one year was lower in patients with grade II or III tumors compared to those with grade 1 or unknown histology (17% compared to 92%, p=0.0054). Cox regression showed that a grade II-III tumor affects progression-free survival (PFS), with a hazard ratio of 5.37 (p=0.011). Median time to progression (MTP) for patients with grade II-III tumors was eight months. MTP was not reached for patients with grade 1/unknown tumors. Reirradiation for recurrent meningioma yields modest tumor control rates but for patients with grade II or III tumors, outcomes are poor.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Timeline depicting the disease course of all 19 patients included in the study, divided into those with “high-grade” (World Health Organization grade II/III) and “low-grade” lesions. Progression, death, and loss to follow-up are indicated where appropriate.
Figure 2
Figure 2
Kaplan–Meier curve of progression free survival (PFS) for the entire patient cohort showing an estimate for the one-year PFS of 66%.
Figure 3
Figure 3
Kaplan–Meier curve of progression free survival (PFS) separated by tumor grade showing that estimates for median PFS were eight months for patients with high-grade tumors and 57 months for other patients.
See this image and copyright information in PMC

References

    1. Central Brain Tumor Registry of the United States; 2009. CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in the United States in 2004–2005 [database on the Internet] Available from: http://www.cbtrus.org.
    1. Mirimanoff RDD, Linggood R, et al. Meningioma: analysis of recurrence and progression following neurosurgical resection. Journal of Neurosurgery. 1985;(62):18–24. - PubMed
    1. Davidson L, Fishback D, Russin JJ, et al. Postoperative Gamma Knife surgery for benign meningiomas of the cranial base. Neurosurg Focus. 2007;23(4):E6. - PubMed
    1. Miralbell R, Linggood RM, de la Monte S, et al. The role of radiotherapy in the treatment of subtotally resected benign meningiomas. J Neurooncol. 1992;13(2):157–64. - PubMed
    1. Taylor BW, Jr, Marcus RB, Jr, Friedman WA, et al. The meningioma controversy: postoperative radiation therapy. Int J Radiat Oncol Biol Phys. 1988;15(2):299–304. - PubMed

Publication types