TY - JOUR
T1 - Radiotherapy for World Health Organization Grade 1 and 2 Intracranial Meningiomas
T2 - A Retrospective Analysis of Efficacy
AU - Klungtvedt, Vanessa
AU - Aunan-Diop, Jan Saip
AU - Poulsen, Frantz Rom
AU - Pedersen, Christian Bonde
AU - Wismann, Joakim
AU - Wang, Eric W.
AU - Dahlrot, Rikke Hedegaard
AU - Halle, Bo
PY - 2025/5
Y1 - 2025/5
N2 - Background: To evaluate the efficacy of radiotherapy (RT) for World Health Organization (WHO) grade 1 and 2 intracranial meningiomas, focusing on the impact of postsurgical tumor volume on treatment outcomes. Methods: Adult patients (aged ≥18 years) with WHO grade 1 or 2 intracranial meningiomas who received RT between January 1, 2019 and April 1, 2022 were identified. Exclusion criteria encompassed known extracranial tumors, preoperative RT or chemotherapy, and insufficient RT modality data. Patients were treated according to the international guidelines. Tumor recurrence was identified on magnetic resonance imaging with a follow-up period until April 2024. Kaplan-Meier estimates for progression-free survival (PFS) calculations and Cox proportional hazard models were performed to evaluate the impact of tumor volume and other covariates on PFS. Results: Among 113 patients with intracranial meningiomas who received RT, 103 met the inclusion criteria. Of these, 84.5% received photon-based and 15.5% proton-based treatment. The cohort was predominantly female (72.8%) with a mean age of 59 years. The 2-year and 5-year PFS rates were 95.6% and 90% for grade 1 tumors, respectively, and 83.3% for grade 2 tumors. Tumors >21 cm
3 postsurgical pre-RT had a significantly higher risk of progression (hazard ratio = 4.35; P = 0.006). Conclusions: Tumor volume was identified as a key prognostic factor for PFS in WHO grade 1 and 2 intracranial meningiomas treated with RT. A critical postsurgical volume threshold of 21 cm
3 significantly influences 2-year and 5-year PFS rates, with patients exceeding this threshold experiencing a 335% increase in risk of progression.
AB - Background: To evaluate the efficacy of radiotherapy (RT) for World Health Organization (WHO) grade 1 and 2 intracranial meningiomas, focusing on the impact of postsurgical tumor volume on treatment outcomes. Methods: Adult patients (aged ≥18 years) with WHO grade 1 or 2 intracranial meningiomas who received RT between January 1, 2019 and April 1, 2022 were identified. Exclusion criteria encompassed known extracranial tumors, preoperative RT or chemotherapy, and insufficient RT modality data. Patients were treated according to the international guidelines. Tumor recurrence was identified on magnetic resonance imaging with a follow-up period until April 2024. Kaplan-Meier estimates for progression-free survival (PFS) calculations and Cox proportional hazard models were performed to evaluate the impact of tumor volume and other covariates on PFS. Results: Among 113 patients with intracranial meningiomas who received RT, 103 met the inclusion criteria. Of these, 84.5% received photon-based and 15.5% proton-based treatment. The cohort was predominantly female (72.8%) with a mean age of 59 years. The 2-year and 5-year PFS rates were 95.6% and 90% for grade 1 tumors, respectively, and 83.3% for grade 2 tumors. Tumors >21 cm
3 postsurgical pre-RT had a significantly higher risk of progression (hazard ratio = 4.35; P = 0.006). Conclusions: Tumor volume was identified as a key prognostic factor for PFS in WHO grade 1 and 2 intracranial meningiomas treated with RT. A critical postsurgical volume threshold of 21 cm
3 significantly influences 2-year and 5-year PFS rates, with patients exceeding this threshold experiencing a 335% increase in risk of progression.
KW - Brain tumor
KW - Intracranial meningioma
KW - Neurosurgery
KW - Progression free survival
KW - Radiotherapy
U2 - 10.1016/j.wneu.2025.123858
DO - 10.1016/j.wneu.2025.123858
M3 - Journal article
C2 - 40054846
SN - 1878-8750
VL - 197
JO - World Neurosurgery
JF - World Neurosurgery
M1 - 123858
ER -