eprintid: 24326 rev_number: 13 eprint_status: archive userid: 1589 dir: disk0/00/02/43/26 datestamp: 2018-04-27 13:56:09 lastmod: 2024-03-27 11:17:21 status_changed: 2018-04-27 13:56:09 type: article metadata_visibility: show creators_name: Shafie, Rami A. creators_name: Czech, Maja creators_name: Kessel, Kerstin A. creators_name: Habermehl, Daniel creators_name: Weber, Dorothea creators_name: Rieken, Stefan creators_name: Bougatf, Nina creators_name: Jäkel, Oliver creators_name: Debus, Jürgen creators_name: Combs, Stephanie E. title: Clinical outcome after particle therapy for meningiomas of the skull base: toxicity and local control in patients treated with active rasterscanning subjects: ddc-610 divisions: i-850300 divisions: i-911400 divisions: i-950400 abstract: Background: Meningiomas of the skull base account for 25–30% of all meningiomas. Due to the complex structure of the cranial base and its close proximity to critical structures, surgery is often associated with substantial morbidity. Treatment options include observation, aggressive surgical intervention, stereotactic or conventional radiotherapy. In this analysis we evaluate the outcome of 110 patients with meningiomas of the skull base treated with particle therapy. It was performed within the framework of the “clinical research group heavy ion therapy” and supported by the German Research Council (DFG, KFO 214). Methods: Between May 2010 and November 2014, 110 Patients with skull base meningioma were treated with particle radiotherapy at the Heidelberg Ion Therapy Center (HIT). Primary localizations included the sphenoid wing (n = 42), petroclival region (n = 23), cavernous sinus (n = 4), sella (n = 10) and olfactory nerve (n = 4). Sixty meningiomas were benign (WHO °I); whereas 8 were high-risk (WHO °II (n = 7) and °III (n = 1)). In 42 cases histology was not examined, since no surgery was performed. Proton (n = 104) or carbon ion (n = 6) radiotherapy was applied at Heidelberg Ion Therapy Center (HIT) using raster-scanning technique for active beam delivery. Fifty one patients (46.4%) received radiotherapy due to tumor progression, 17 (15.5%) after surgical resection and 42 (38.2%) as primary treatment. Results: Median follow-up in this analysis was 46,8 months (95% CI 39,9–53,7; Q1-Q3 34,3–61,7). Particle radiotherapy could be performed safely without toxicity-related interruptions. No grade IV or V toxicities according to CTCAE v4.0 were observed. Particle RT offered excellent overall local control rates with 100% progression-free survival (PFS) after 36 months and 96.6% after 60 months. Median PFS was not reached due to the small number of events. Histology significantly impacted PFS with superior PFS after 5 years for low-risk tumors (96.6% vs. 75.0%, p = 0,02). Overall survival was 96.2% after 60 months and 92.0% after 72 months from therapy. Of six documented deaths, five were definitely not and the sixth probably not meningioma-related. Conclusion Particle radiotherapy is an excellent treatment option for patients with meningiomas of the skull base and can lead to long-term tumor control with minimal side effects. Other prospective studies with longer follow-up will be necessary to further confirm the role of particle radiotherapy in skull base meningioma. date: 2018 publisher: BioMed Central id_scheme: DOI ppn_swb: 1655280945 own_urn: urn:nbn:de:bsz:16-heidok-243263 language: eng bibsort: SHAFIERAMICLINICALOU2018 full_text_status: public publication: Radiation Oncology volume: 13 number: 54 place_of_pub: London pagerange: 1-11 issn: 1748-717X citation: Shafie, Rami A. ; Czech, Maja ; Kessel, Kerstin A. ; Habermehl, Daniel ; Weber, Dorothea ; Rieken, Stefan ; Bougatf, Nina ; Jäkel, Oliver ; Debus, Jürgen ; Combs, Stephanie E. (2018) Clinical outcome after particle therapy for meningiomas of the skull base: toxicity and local control in patients treated with active rasterscanning. Radiation Oncology, 13 (54). pp. 1-11. ISSN 1748-717X document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/24326/1/13014_2018_Article_1002.pdf