Role of radiation therapy in treating intracranial meningiomas

✓Surgery is the mainstay for many patients with meningiomas, and it remains the standard. In large single-institution series, gross-total resection has been reported to achieve 5-, 10-, and 15-year recurrence-free survival rates of approximately 90, 80, and 70%, respectively. There are a growing number of series of patients with prolonged follow-up in which authors have evaluated fractionated external-beam radiation therapy (EBRT) either as an adjuvant to surgery for subtotally resected, recurrent, or higher-grade meningiomas, or as an alternative to surgery. The primary focus of this review is EBRT, but to lend perspective, a comparative analysis of surgery and radiosurgery is also provided.

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Evolution of Surgical Approaches in the Treatment of Petroclival Meningiomas: A Retrospective Review

Operative Neurosurgery ◽

10.1227/01.neu.0000303218.61230.39 ◽

2007 ◽

Vol 61 (suppl_5) ◽

pp. ONS202-ONS211 ◽

Cited By ~ 36

Author(s):

Nicholas C. Bambakidis ◽

U. Kumar Kakarla ◽

Louis J. Kim ◽

Peter Nakaji ◽

Randall W. Porter ◽

...

Keyword(s):

Survival Rates ◽

Progression Free Survival ◽

Surgical Approaches ◽

Single Institution ◽

Short Term ◽

Total Resection ◽

Free Survival ◽

Petroclival Meningioma ◽

Petroclival Meningiomas

Abstract Objective: We examined the surgical approaches used at a single institution to treat petroclival meningioma and evaluated changes in method utilization over time. Methods: Craniotomies performed to treat petroclival meningioma between September of 1994 and July of 2005 were examined retrospectively. We reviewed 46 patients (mean follow-up, 3.6 yr). Techniques included combined petrosal or transcochlear approaches (15% of patients), retrosigmoid craniotomies with or without some degree of petrosectomy (59% of patients), orbitozygomatic craniotomies (7% of patients), and combined orbitozygomatic-retrosigmoid approaches (19% of patients). In 18 patients, the tumor extended supratentorially. Overall, the rate of gross total resection was 43%. Seven patients demonstrated progression over a mean of 5.9 years. No patients died. At 36 months, the progression-free survival rate for patients treated without petrosal approaches was 96%. Of 14 patients treated with stereotactic radiosurgery, none developed progression. Conclusion: Over the study period, a diminishing proportion of patients with petroclival meningioma were treated using petrosal approaches. Utilization of the orbitozygomatic and retrosigmoid approaches alone or in combination provided a viable alternative to petrosal approaches for treatment of petroclival meningioma. Regardless of approach, progression-free survival rates were excellent over short-term follow-up period.

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The role of primary surgery and external beam radiation therapy in the management of non-metastatic ductal prostate cancer: 20-year outcomes from a single institution experience

European Urology Supplements ◽

10.1016/s1569-9056(18)31659-2 ◽

2018 ◽

Vol 17 (2) ◽

pp. e1175-e1176

Author(s):

S. Francavilla ◽

L. Triggiani ◽

C. Palumbo ◽

L. Bardoscia ◽

R. Tellini ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

External Beam Radiation Therapy ◽

External Beam Radiation ◽

External Beam ◽

Single Institution ◽

Beam Radiation ◽

Primary Surgery

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Chemoreduction and Local Ophthalmic Therapy for Intraocular Retinoblastoma

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.1.12 ◽

2000 ◽

Vol 18 (1) ◽

pp. 12-12 ◽

Cited By ~ 159

Author(s):

Debra L. Friedman ◽

Bruce Himelstein ◽

Carol L. Shields ◽

Jerry A. Shields ◽

Michael Needle ◽

...

Keyword(s):

Radiation Therapy ◽

Systemic Chemotherapy ◽

Gastrointestinal Symptoms ◽

External Beam Radiation ◽

Beam Radiation ◽

Free Survival ◽

Intraocular Retinoblastoma ◽

Ophthalmic Therapy ◽

Ophthalmic Treatment

PURPOSE: To study the effectiveness of combined systemic chemotherapy and local ophthalmic therapy for retinoblastoma with the goal of avoiding enucleation and external-beam radiation therapy (EBRT). PATIENTS AND METHODS: This was a prospective, nonrandomized, single-arm clinical trial. Seventy-five eyes were followed in 47 children. Patients were treated with a six-cycle protocol of vincristine, etoposide, and carboplatin. Most (83%) also received ophthalmic treatment (cryotherapy, laser photocoagulation, thermotherapy, or plaque radiation therapy) during and/or after the chemotherapy. RESULTS: With a median follow-up of 13 months, event-free survival was 74%, with an event defined as enucleation and/or EBRT. Six children required EBRT in seven eyes (9%); five required enucleation of one eye (7%); five required a combination of EBRT and enucleation in six eyes (8%). Reese-Ellsworth groups 1, 2, and 3 eyes had excellent results, with avoidance of EBRT or enucleation in all 39. Treatment of groups 4 and 5 was less successful, with 33% of six eyes and 53% of 30 eyes, respectively, requiring EBRT and/or enucleation. Toxicities from chemotherapy were mild and included cytopenias (89%), fever and neutropenia (28%), infection (9%), and gastrointestinal symptoms, dehydration, and vincristine neurotoxicity (40%). No patients developed a second malignancy, metastatic disease, renal disease, or ototoxicity. CONCLUSION: In retinoblastoma patients with Reese-Ellsworth eye groups 1, 2, or 3, systemic chemotherapy used with local ophthalmic therapies can eliminate the need for enucleation or EBRT without significant systemic toxicity. More effective therapy is required for Reese-Ellsworth eye groups 4 and 5.

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