KEY TAKEAWAYS
- The study aimed to report outcomes from a substantial series of IM treated with curative-intent proton therapy.
- The study’s findings concluded proton therapy effectively treated IM with acceptable toxicity, representing a substantial patient cohort.
Alberto Iannalfi and the team aimed to present the outcomes of a significant series of intracranial meningiomas (IM) and brain cancer treated with curative-intent proton therapy (PT).
In a retrospective analysis spanning 2014 to 2021, all patients with consecutive IM were evaluated. PT prescribed a median dose of 55.8 Gy relative biological effectiveness (RBE) for benign/radiologically diagnosed tumors and 66 GyRBE for atypical/anaplastic cases.
The study assessed local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), overall survival (OS), and radionecrosis-free survival (RNFS) using Kaplan-Meier analysis. Univariable analysis identified potential prognostic factors for clinical outcomes. Toxicity was graded according to CTCAE version 5.0.
About 167 patients were included, with a median follow-up of 41 months (range, 6–99), 12 patients (7%) developed local tumor recurrence, occurring at a median of 39 months. The 5-year LRFS rate for the entire cohort was 88%, showing a significant discrepancy between benign/radiologically diagnosed and atypical/anaplastic IM (98% vs. 47%, P< 0.001).
This distinction persisted in the 5-year OS and DRFS rates. Patients aged ≤ 56 years had notably better outcomes, while lower prescribed doses and skull base locations correlated with higher RNFS rates.
Acute Grade 3 toxicities were observed in 2 patients (1.2%), with 3 patients (1.8%) experiencing late Grade 3 toxicities. No Grade 4 or 5 adverse events were reported.
The results suggested that PT is effective with a manageable toxicity profile. It represents one of the largest series to date that includes patients with IM who were treated with this modality.
No funding was provided.
Source: https://link.springer.com/article/10.1007/s11060-024-04751-x
Iannalfi, A., Riva, G., Lillo, S. et al.(2024). “Proton therapy for intracranial meningioma: a single-institution retrospective analysis of efficacy, survival and toxicity outcomes.” J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04751-x