Original contribution
The Meningioma Controversy: Postoperative radiation therapy

https://doi.org/10.1016/S0360-3016(98)90008-6Get rights and content

Abstract

Total surgical excision is the main goal of therapy for intracranial meningiomas. The controversy today involves the efficacy of postoperative radiation therapy. To evaluate this question, 132 patients with benign intracranial meningiomas, treated between October 1964 and April 1985, were evaluated. All patients had a minimum 2-year follow-up. The actuarial local control rates at 10 years for the three treatment groups were as follows: subtotal excision alone, 18%; subtotal excision plus postoperative radiation therapy, 82%; and total excision alone, 77%. The actuarial determinate survival rates at 10 years were 49%, 81%, and 93%, respectively. Postoperative radiation therapy was also effective for patients treated at the time of the first recurrence, with an actuarial local control rate at 10 years after salvage treatment of 30% for patients treated with surgery alone and 89% for patients receiving postoperative radiation therapy at the time of salvage. This analysis suggests that radiation therapy has a significant role in the treatment of subtotally excised and recurrent intracranial meningiomas.

References (21)

  • A.R. Forbes et al.

    Radiation therapy in the treatment of meningioma: the Joint Center for Radiation Therapy experience 1970–1982

    J. Clin. Oncol.

    (1984)
  • A.B. Adegbite et al.

    The recurrence of intracranial meningiomas after surgical treatment

    J. Neurosurg.

    (1983)
  • N.M. Barbaro et al.

    Radiation therapy in the treatment of partially resected meningiomas

    Neurosurgery

    (1987)
  • P.C. Burger et al.

    Surgical Pathology of the Nervous System and Its Coverings

  • R.J. Carella et al.

    Role of radiation therapy in the management of meningioma

    Neurosurgery

    (1982)
  • R.C. Chan et al.

    Morbidity, mortality, and quality of life following surgery for intracranial meningiomas. A retrospective study in 257 cases

    J. Neurosurg

    (1984)
  • T. Colton

    Statistics in Medicine

  • C.B. Courville

    Pathology of the Central Nervous System. A Study Based Upon a Survey of Lesions Found in a Series of Thirty Thousand Autopsies

    (1945)
  • H. Cushing et al.

    Meningiomas, Their Classification, Regional Behavior, Life History, and Surgical End Results

    H. Cushing et al.

    Meningiomas, Their Classification, Regional Behavior, Life History, and Surgical End Results

  • S.J. Cutler et al.

    Maximum utilization of the life table method in analyzing survival

    J. Chronic Dis.

    (1958)
There are more references available in the full text version of this article.

Cited by (251)

  • High-risk Meningioma: Initial Outcomes From NRG Oncology/RTOG 0539

    2020, International Journal of Radiation Oncology Biology Physics
    Citation Excerpt :

    The present report concerns the high-risk cohort (group 3) composed of patients with a newly diagnosed or recurrent WHO grade III meningioma of any resection extent, a recurrent WHO grade II tumor of any resection extent, or a newly diagnosed WHO grade II meningioma after subtotal resection (STR). In support of this grouping, many reports have found that outcomes with WHO grade II meningioma are worse after either recurrence or STR, approximating those for patients with new or recurrent WHO grade III meningioma.9-19 This phase 2 cooperative group trial was approved by the institutional review boards and ethical committees at each participating study site, and documentation was received at the clinical trials central office.

  • Adjuvant Radiotherapy Did Not Reduce Recurrence of World Health Organization Grade I Meningiomas with Venous Sinus Involvement: A Propensity Score Adjusted Analysis and Literature Review

    2019, World Neurosurgery
    Citation Excerpt :

    Of note, among the available data in meningiomas is the venous sinus involvement as an inclusion criterion of the present cohort. We think this plays a crucial role in surgical strategy and decision regarding the need for adjuvant therapy because perioperative morbidity may be increased because of venous sinus injury, thrombosis, and a higher proportion of partial resection.7,15 SSS involvement was remarkably associated with a higher recurrence rate, which highlights the importance of tumor location and which venous sinus was invaded by the lesion.

View all citing articles on Scopus

Presented at the 29th Annual Meeting of the American Society for Therapeutic Radiology and Oncology, October 18–23, 1987, Boston, MA.

View full text