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. 2022 Mar;40(1):29-36.
doi: 10.3857/roj.2021.00563. Epub 2022 Mar 15.

Trends in the use of radiation for meningioma across the United States

Hirsch Matani  1 , Stephen Abel  1 , Alexander Yu  2 , Stephen M Karlovits  1 , Rodney E Wegner  1
Affiliations

Trends in the use of radiation for meningioma across the United States

Hirsch Matani et al. Radiat Oncol J. 2022 Mar.

Abstract

Purpose: Meningiomas are tumors originating from arachnoid cap cells on the surface of the brain or spinal cord. Treatment differs by grade but can consist of observation, surgery, radiation therapy or both. We utilized the National Cancer Database (NCDB) to compare trends in the use stereotactic radiosurgery (SRS) and external beam radiation therapy (EBRT) in the management of meningioma.

Materials and methods: We queried the NCDB from 2004-2015 for meningioma patients (grade 1-3) treated with radiation therapy, either SRS or EBRT. Multivariable logistic regression was used to identify predictors of each treatment and to generate a propensity score. Propensity adjusted Kaplan-Meier survival curve analysis and multivariable Cox hazards ratios were used to identify predictors of survival.

Results: We identified 5,406 patients with meningioma meeting above criteria with 45%, 44%, and 11% having World Health Organization (WHO) grade 1, 2, and 3 disease, respectively. Median follow up was 43 months. Predictors for SRS were grade 1 disease, distance from treatment facility, and histology. The only predictor of EBRT was grade 3 disease. Treatment year, histology, race and female sex were associated with improved survival. Five- and 10-year survival rates were 89.2% versus 72.6% (p < 0.0001) and 80.3% versus 61.4% (p = 0.29) for SRS and EBRT respectively. After propensity matching 226 pairs were generated. For SRS, 5-year survival was not significantly improved at 88.2% compared with EBRT (p = 0.056).

Conclusion: In the present analysis, predictors of SRS utilization in management of meningioma include WHO grade 1 disease, distance from treatment facility and histology whereas conventional EBRT utilization was associated with grade 2 and 3 disease. Future studies need to be performed in order to optimize management of atypical and malignant meningioma.

Keywords: Meningioma; Radiosurgery; Radiotherapy.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Consort diagram of patients included in the analysis. NCDB, National Cancer Database; WHO, World Health Organization.
Fig. 2.
Fig. 2.
Overall survival for patients with meningioma receiving external beam radiation therapy (EBRT).
Fig. 3.
Fig. 3.
Overall survival for patients with meningioma receiving stereotactic radiosurgery (SRS).
See this image and copyright information in PMC

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