Stereotactic radiotherapy of benign meningioma in the elderly: clinical outcome and toxicity in 121 patients.

Abstract

To investigate the outcome of definitive stereotactic-based radiotherapy in elderly patients (≥70 years of age) with benign intracranial meningiomas. 121 patients were treated with either fractionated stereotactic radiotherapy (FRTS; n=74), hypofractionated FSRT (hFSRT; n=35) or stereotactic radiosurgery (SRS; n=12), depending on tumor size and location. Local control (LC), overall survival (OS), cause-specific survival (CSS), symptomatology and acute and late toxicity were assessed. The prognostic value of factors such as age, sex, tumor location, Karnofsky performance scale, target volume and radiotherapy schedule was examined. The median follow-up was 40 months (range, 12-124 months). LC, OS and CSS at 3 years were 98.3%, 92% and 99% and at 5 years they accounted 94.7%, 79% and 94.3%, respectively. We failed to identify any significant prognostic factor for outcome. Only Grade I-II toxicity was observed, whereas no new neurologic deficits or treatment-related mortality were encountered. This is the first study to assess the outcome following radiotherapy in elderly patients with intracranial meningiomas. The high local control, the low toxicity and the lack of treatment-associated mortality make stereotactic radiotherapy an attractive option in an age population where neurosurgery is often correlated with some mortality.