CyberKnife Stereotactic Radiosurgery and Hypofractionated Stereotactic Radiotherapy As First-line Treatments for Imaging-diagnosed Intracranial Meningiomas
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- MANABE Yoshihiko
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
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- MURAI Taro
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
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- OGINO Hiroyuki
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City West Medical Center
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- TAMURA Takeshi
- Department of Radiation Oncology, Suzuka Chuo General Hospital
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- IWABUCHI Michio
- Department of Radiation Oncology, Yokohama CyberKnife Center
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- MORI Yoshimasa
- Department of Radiology and Radiation Oncology, Aichi Medical University
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- IWATA Hiromitsu
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City West Medical Center
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- SUZUKI Hirochika
- Department of Radiology, Tsushima City Hospital
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- SHIBAMOTO Yuta
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
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抄録
<p>Definitive radiotherapy is an important alternative treatment for meningioma patients who are inoperable or refuse surgery. We evaluated the efficacy and toxicity of CyberKnife-based stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (hSRT) as first-line treatments for intracranial meningiomas that were diagnosed using magnetic resonance imaging (MRI) and/or computed tomography (CT). Between February 2005 and September 2015, 41 patients with intracranial meningiomas were treated with CyberKnife-based SRS or hSRT. Eleven of those tumors were located in the skull base. The median tumor volume was 10.4 ml (range, 1.4–56.9 ml). The median prescribed radiation dose was 17 Gy (range, 13–20 Gy to the 61–88% isodose line) for SRS (n = 9) and 25 Gy (range, 14–38 Gy to the 44–83% isodose line) for hSRT (n = 32). The hSRT doses were delivered in 2 to 10 daily fractions. The median follow-up period was 49 months (range, 7–138). The 5-year progression-free survival rate (PFS) for all 41 patients was 86%. The 3-year PFS was 69% for the 14 patients with tumor volumes of ≥13.5 ml (30 mm in diameter) and 100% for the 27 patients with tumor volumes of <13.5 ml (P = 0.031). Grade >2 toxicities were observed in 5 patients (all of them had tumor volumes of ≥13.5 ml). SRS and hSRT are safe and effective against relatively small (<13.5 ml) meningiomas.</p>
収録刊行物
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 57 (12), 627-633, 2017
一般社団法人 日本脳神経外科学会
