Fractionated stereotactic radiation therapy improves cranial neuropathies in patients with skull base meningiomas: a retrospective cohort studyReportar como inadecuado




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Radiation Oncology

, 7:225

First Online: 28 December 2012Received: 19 March 2012Accepted: 18 December 2012DOI: 10.1186-1748-717X-7-225

Cite this article as: Shen, X., Andrews, D.W., Sergott, R.C. et al. Radiat Oncol 2012 7: 225. doi:10.1186-1748-717X-7-225

Abstract

BackgroundSkull base meningiomas commonly present with cranial neuropathies. Fractionated stereotactic radiation therapy FSRT has been used to treat these tumors with excellent local control, but rates of improvement in cranial neuropathies have not been well defined. We review the experience at Thomas Jefferson University using FSRT in the management of these patients with a focus on symptom outcomes.

MethodsWe identified 225 cases of skull base meningiomas treated with FSRT at Thomas Jefferson University from 1994 through 2009. The target volume was the enhancing tumor, treated to a standard prescription dose of 54 Gy. Symptoms at the time of RT were classified based on the cranial nerve affected. Logistic regression was performed to determine predictors of symptom improvement after FSRT.

ResultsThe median follow-up time was 4.4 years. In 92% of cases, patients were symptomatic at the time of RT; the most common were impaired visual field-acuity 58% or extraocular movements 34%. After FSRT, durable improvement of at least one symptom occurred in 57% of cases, including 40% of visual acuity-visual field deficits, and 40% of diplopia-ptosis deficits. Of all symptomatic patients, 27% experienced improvement of at least one symptom within 2 months of the end of RT.

ConclusionsFSRT is very effective in achieving improvement of cranial neuropathies from skull base meningiomas, particularly visual symptoms. Over half of treated patients experience a durable improvement of at least one symptom, frequently within 2 months from the end of RT.

KeywordsFractionated stereotactic radiation therapyMeningiomaSymptomOutcomeSkull baseAbbreviationsCNCranial nerve

CTVClinical target volume

GTVGross tumor volume

FSRTFractionated stereotactic radiation therapy

HRHazard ratio

IMRTIntensity modulated radiation therapy

LINACLinear accelerator

OROdds ratio

PTVPlanning target volume

RTRadiation therapy

RIONRadiation induced optic neuritis

SRSStereotactic radiosurgery.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-7-225 contains supplementary material, which is available to authorized users.

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Autor: XingleiShen - DavidWAndrews - RobertCSergott - JamesJEvans - WalterJCurran - MitchellMachtay - RubenFragoso - HarrietEldredge - Co

Fuente: https://link.springer.com/



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