Outcomes of Meningioma Patients Undergoing Stereotactic Radiotherapy

Yıl 2023, Cilt: 13 Sayı: 3, 426 - 432, 31.05.2023

Ela Delikgöz Soykut , Dönay Aksan Evrim Şavlı Salih Buğra Yılmaz , Hatice Tataroğlu

https://doi.org/10.16899/jcm.1256587

Öz

Aim: Innovations in radiotherapy have paved the way for alternative approaches for the treatment of meningioma, and in this context, radiosurgery has begun to be used in the treatment of meningioma. This study aimed to examine the clinical results of radiosurgery in the treatment of meningioma and to show whether it achieves the main goals, especially in terms of the possibility of tumor control and the success of preventing progression.
Materials and Methods: Primary, residual, and recurrent meningioma treated with stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) between 2013 and 2020 were evaluated retrospectively. Study endpoints were overall survival (OS), progression free survival (PFS), and local control (LC).
Results: 73 patients and 81 lesions were analyzed. The median duration of the follow-up period was 49 months (range, 7–138 months). 5- and 7-y OS and PFS were 87.6%, 78.9%; 82.9% and 82.9%, respectively. The tumor control rate was 94.6%. In univariate analysis, gender (p=0.007), radiosurgery for recurrence (p=0.011) and number of lesions (p=0.030) were found to be factors affecting OS, and number of lesions (p<0.001), grade (p=0.048) and tumor size (p=0.047) were found to be factors affecting PFS. Number of lesions (p=0.022) was remained prognostic factor for PFS in the multivariate analysis.
Conclusion: Since SRS/SRT can provide high tumor control in the management of meningioma, it can be preferred as an alternative treatment method, especially in patients who are diagnosed radiologically, who are not candidates for surgery or who refuse surgical treatment, as well as in cases of residual and recurrence in the post-surgical period.

Anahtar Kelimeler

meningioma, Stereotactic Radiosurgery, Stereotactic Radiotherapy

Stereotaktik Radyoterapi Uygulanan Menengiom Tanılı Olgularda Tedavi Sonuçlarımız

Öz

Amaç: Radyoterapideki yenilikler menengiom tedavisinde alternatif yaklaşımların önünü açmış ve bu bağlamda radyocerrahi menengiom tedavisinde kullanılmaya başlanmıştır. Bu çalışma, radyocerrahinin menengiom tedavisinde klinik sonuçlarını incelemek ve özellikle tümör kontrolü olasılığı ve ilerlemeyi önleme başarısı açısından ana hedeflere ulaşıp ulaşmadığını göstermeyi amaçladı.
Gereç ve Yöntem: 2013-2020 yılları arasında stereotaktik radyocerrahi (SRC) ve stereotaktik radyoterapi (SRT) ile tedavi edilen primer, rezidüel ve nüks menengiomlar retrospektif olarak değerlendirildi. Çalışma son noktaları, genel sağkalım (GS), progresyonsuz sağkalım (PS) ve lokal kontrol (LK) idi.
Bulgular: 73 hasta ve 81 lezyon analiz edildi. Medyan takip süresi 49 aydı (aralık, 7-138 ay). 5- ve 7-y GS ve PS sırasıyla %87,6, %78,9; ve %82,9, %82,9’du. Tümör kontrol oranı %94,6’ydı. Tek değişkenli analizde cinsiyet (p=0,007), nüks nedeniyle radyocerrahi (p=0,011) ve lezyon sayısı (p=0,030) GS'ı etkileyen faktörler olarak bulundu ve lezyon sayısı (p<0,001), grad (p= 0,048) ve tümör boyutu (p=0,047) PS'ı etkileyen faktörler olarak bulundu. Çok değişkenli analizde lezyon sayısı (p=0,022) PS için prognostik faktör olarak kaldı.
Sonuç: SRC/SRT menengiom tedavisinde yüksek tümör kontrolü sağlayabildiği için özellikle radyolojik olarak tanı konulan, cerrahiye aday olmayan veya cerrahi tedaviyi reddeden hastalarda, aynı zamanda ameliyat sonrası dönemde rezidüel ve nüks durumlarında alternatif bir tedavi yöntemi olarak tercih edilebilir.

Anahtar Kelimeler

Menengiom, Stereotaktik Radyocerrahi, Stereotaktik Radyoterapi

Kaynakça

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