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Original Article

The Results of Radiation Therapy as Definitive, Postoperative, and Salvage Therapy for Meningioma

Jihae Lee, Soo Mee Lim1, Myungsoo Kim, Hyunsuk Suh
The Ewha Medical Journal 2013;36(2):112-117. Published online: September 26, 2013

Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Korea.

1Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Soo Mee Lim. Department of Radiology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-6022, Fax: 82-2-2650-5301, soomee@ewha.ac.kr
• Received: January 17, 2013   • Accepted: January 30, 2013

Copyright © 2013. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Radiation therapy has multiple roles in the treatment of meningioma although surgery remains the primary treatment of choice. In this retrospective study, we report the results of radiation therapy for meningioma as definitive, postoperative or salvage therapies.
  • Methods
    Seventeen patients diagnosed with meningioma were treated with radiation therapy in our institute from May 2000 to October 2009. Radiation therapies were performed as definitive therapies in 8 patients, as postoperative therapies in 5 and as salvage therapies in 4. Nine patients received stereotactic radiosurgery (SRS), 2 patients fractionated stereotactic radiotherapy (FSRT), and 5 patients 3-dimensional conformal radiotherapy (3DCRT). Radiation dose were 12 to 20 Gy for SRS, 36 Gy in 9 fractions for FSRT and 50.4 Gy in 28 fractions for 3DCRT. Follow-up imaging study of computed tomography or magnetic resonance imaging was performed at 6 to 12 months intervals and neurologic exam was performed with an interval less than 6 months.
  • Results
    The median follow-up duration was 38 months (range, 12 to 85 months). Tumor progression after radiation therapy developed in one patient. The reduction of tumor volume measured on follow-up images were more than 20% in 4 patients and minimal change of tumor volume less than 20% were observed in 12 patients. Peritumoral edema developed in 4 patients and disappeared without any treatment. One patient had radiation necrosis.
  • Conclusion
    Our experience is consistent with the current understanding that radiotherapy is as an effective and safe treatment modality for meningiomas when the tumor cannot be resected completely or when recurred after surgery.
  • Keywords: Mutation meningioma; Radiosurgery; Radiotherapy
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Fig. 1
Examples of radiation therapy planning of (A) stereotactic radiosurgery as a salvage therapy for a patient with recurrent meningioma, (B) fractionated stereotactic radiotherapy as a definitive therapy for a patient with unresectable tumor due to a high risk of cranial nerve damage after a surgery and (C) 3-dimensional conformal radiotherapy as a postoperative radiotherapy for a patient with residual tumor after surgical resection.
emj-36-112-g001.jpg
Table 1
Patients characteristics

WHO, World Health Organization.

emj-36-112-i001.jpg
Table 2
Treatment parameters (n=19)

SRS, stereotactic radiosurgery; FSRT, fractionated stereotactic radiotherapy; 3DCRT, 3-dimensional conformal radiotherapy.

emj-36-112-i002.jpg
Table 3
Simpson classification of extent of resection [10]
emj-36-112-i003.jpg

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      The Results of Radiation Therapy as Definitive, Postoperative, and Salvage Therapy for Meningioma
      Ewha Med J. 2013;36(2):112-117.   Published online September 26, 2013
      DOI: https://doi.org/10.12771/emj.2013.36.2.112
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      The Results of Radiation Therapy as Definitive, Postoperative, and Salvage Therapy for Meningioma
      Ewha Med J. 2013;36(2):112-117.   Published online September 26, 2013
      DOI: https://doi.org/10.12771/emj.2013.36.2.112
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      The Results of Radiation Therapy as Definitive, Postoperative, and Salvage Therapy for Meningioma
      Image
      Fig. 1 Examples of radiation therapy planning of (A) stereotactic radiosurgery as a salvage therapy for a patient with recurrent meningioma, (B) fractionated stereotactic radiotherapy as a definitive therapy for a patient with unresectable tumor due to a high risk of cranial nerve damage after a surgery and (C) 3-dimensional conformal radiotherapy as a postoperative radiotherapy for a patient with residual tumor after surgical resection.

      Fig. 1

      The Results of Radiation Therapy as Definitive, Postoperative, and Salvage Therapy for Meningioma

      Patients characteristics

      WHO, World Health Organization.

      Treatment parameters (n=19)

      SRS, stereotactic radiosurgery; FSRT, fractionated stereotactic radiotherapy; 3DCRT, 3-dimensional conformal radiotherapy.

      Simpson classification of extent of resection [10]
      Table 1 Patients characteristics

      WHO, World Health Organization.

      Table 2 Treatment parameters (n=19)

      SRS, stereotactic radiosurgery; FSRT, fractionated stereotactic radiotherapy; 3DCRT, 3-dimensional conformal radiotherapy.

      Table 3 Simpson classification of extent of resection [10]

      Table 1

      Table 2

      Table 3

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