Adjuvant Radiotherapy in Grade II, Atypical Meningioma of the Skull Base

• Type of Material: Article
• Authors: David P Bray, Emory University; Bryan Buster, Emory University; Joseph W Quillin, Emory University; Robert H Press, New York Proton Center; Bree Eaton, Emory University; Jeffrey Olson, Emory University
• Language: English
• Date: 2021-09-21
• Publisher: THIEME MEDICAL PUBL INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Thieme. All rights reserved.
• License: Creative Commons Attribution-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1055/s-0041-1735879
• Title of Journal or Parent Work: JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE
• Volume: 83
• Issue: 04
• Start Page: 418
• End Page: 422
• Grant/Funding Information: D.P.B. is partially supported by the Nell W. and William S. Elkin Research Fellowship in Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, Georgia, United States.
• Keywords: radiotherapy; INTRACRANIAL MENINGIOMAS; meningioma; GROSS TOTAL RESECTION; skull base; atypical meningioma; CLASSIFICATION; Life Sciences & Biomedicine; Science & Technology; ORGANIZATION; Neurosciences & Neurology; Clinical Neurology; MALIGNANT MENINGIOMAS; RECURRENCE; TUMORS; Surgery
• Research Categories: Health Sciences, Oncology; Health Sciences, Medicine and Surgery

Abstract

Introduction  Atypical meningiomas (AM) are meningiomas that are more aggressive than their grade-I counterparts and have a higher rate of recurrence. The effect of adjuvant radiotherapy (ART) on AM of the skull base is not defined. Methods  A retrospective review of all AM's of the skull base primarily resected at our institution from 1996 to 2018 was completed. ART was defined as radiotherapy (RT) that occurred within 6 months of initial resection, regardless of Simpson's grade. Minimum time length of follow-up after resection was 2 years. Statistical analysis was performed using SAS. Results  There were a total of 59 skull base-located (SBL) AMs resected at our institution from 1996 to 2018. The average age of our cohort was 53.2 years. Gross total resection, defined as Simpson's grades I to III resection, was achieved in 36 (61%) of cases. Thirty-five of 59 (59%) patients received ART. Recurrence was observed in 14 patients (24%), and mean time to recurrence was 63.8 months. Patients who received ART had a lower observed rate of recurrence (8 vs. 46%); however, time to recurrence was not significantly different between the two populations. Conclusion  We observe that AM in the skull base location have higher recurrence rates than we would expect from grade-I meningioma. These data suggest that ART may offer benefit to the overall observed frequency of recurrence of SBL AM; however, the time to recurrence between patients who received ART and those who did not was not statistically significant in survival analysis.