Re-irradiation of anaplastic meningioma: higher dose and concomitant Bevacizumab may improve progression-free survival.
Humans
Meningioma
/ radiotherapy
Bevacizumab
/ therapeutic use
Retrospective Studies
Middle Aged
Male
Female
Meningeal Neoplasms
/ radiotherapy
Aged
Re-Irradiation
/ adverse effects
Adult
Neoplasm Recurrence, Local
/ pathology
Progression-Free Survival
Radiotherapy Dosage
Aged, 80 and over
Antineoplastic Agents, Immunological
/ therapeutic use
Survival Rate
Anaplastic meningioma
Bevacizumab
Dose escalation
Re-irradiation
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
02 Oct 2024
02 Oct 2024
Historique:
received:
23
04
2024
accepted:
06
07
2024
medline:
3
10
2024
pubmed:
3
10
2024
entrez:
2
10
2024
Statut:
epublish
Résumé
Anaplastic meningiomas, categorized as WHO grade 3 tumors, are rare and highly aggressive, accounting for 1-2% of all meningioma cases. Despite aggressive treatment, including surgery and Radiation, they exhibit a high recurrence rate and poor survival outcomes. The aggressive histopathological features emphasize the urgent need for effective management strategies. A retrospective multi-institutional analysis was conducted on patients with recurrent anaplastic meningioma who underwent re-irradiation between 2017 and 2023. Clinical, dosimetric, and outcome data were collected and analyzed, focusing on local control, progression free survival and treatment-related adverse events. Thirty-four cases were analyzed, with a median follow-up 11 months after re-irradiation. Progression-free survival at 12 months was 61.9%, with higher doses correlating with better outcomes. Concomitant Bevacizumab improves progression-free survival and reduces the risk of radiation necrosis. CDKN2A homozygote deletion correlated with a higher risk of local failure. Symptomatic radiation necrosis occurred in 20.5% of cases, but its incidence was lower with concomitant Bevacizumab treatment. Re-irradiation presents a viable option for recurrent anaplastic meningioma despite the associated risk of radiation necrosis. Higher doses with concomitant Bevacizumab improve clinical outcomes and reduce toxicity. Individualized treatment approaches are necessary, emphasizing the importance of further research to refine management strategies for this challenging disease.
Identifiants
pubmed: 39358739
doi: 10.1186/s13014-024-02486-7
pii: 10.1186/s13014-024-02486-7
doi:
Substances chimiques
Bevacizumab
2S9ZZM9Q9V
Antineoplastic Agents, Immunological
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
135Informations de copyright
© 2024. The Author(s).
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