Earlier and sustained response with incidental use of cardiovascular drugs among patients with low- to medium-grade meningiomas treated with radiosurgery (SRS) or stereotactic radiotherapy (SRT).

Abstract

Beneficial outcome for cancer treated with radiotherapy (RT) and β-blockers has been reported. We hypothesize a potential combined impact of stereotactic RT with incidental use of cardiovascular drugs also in meningiomas. In 64 patients with 70 intracranial meningiomas (male/female=17/53; median follow-up=2 years) from a prospective database with sustained RT/cardiovascular drug therapy tumor response (progression, stable disease, regression) was evaluated at predefined follow-up intervals of 3, 12 and 24 months based on MR-imaging. For this retrospective cohort analysis stepwise univariate and multivariate analyses for group comparison were performed. Between groups analysis and stepwise uni- and multivariate analysis was performed. At one year follow-up there was a significant better tumor response for patients with antihypertensives use (p=0.008) and radiosurgery (SRS) (p=0.054), the difference between patients with and without antihypertensive medication remains significant in multivariate analysis. Two years after RT, only patients with β-blocker use had a significant better response to RT (p=0.032). Additionally, for the use of β-blockers a trend toward significance for early tumor response at 3 months compared to the control group was observed (p(one tailed)=0.059). Our data suggest that concomitant antihypertensive medication (especially β-blockers) may lead to an earlier and sustained response in stereotactic irradiated low- to medium-grade intracranial meningiomas by affecting the β-adrenergic pathways.