Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Combemale, 59020, Lille cedex, France.
Departement de radiotherapie, Institut de cancérologie de Lorraine, 6 Avenue de Bourgogne, 54519, Vandœuvre-les-Nancy, France.
Sci Rep. 2018 Sep 12;8(1):13666. doi: 10.1038/s41598-018-32124-8.
We evaluated efficacy and tolerance of hypofractionated stereotactic radiation treatment (hFSRT) in the management of intracranial meningiomas. Between December 2008 and June 2016, 126 patients with 136 intracranial meningiomas were treated with robotic hFSRT. hFSRT was performed as primary irradiation and as a salvage option for the local recurrence after prior radiotherapy. The median prescription dose was 25 Gy (12-40) with a median number of fractions of 5 (3-10). After a median follow-up of 20.3 months (range 1-77 months), the 24-months local control (LC) rate was 81% in the primary hFSRT group and 39% after hFSRT in the re-irradiation group (p=0.002). The clinical control rate of symptoms in the overall population was 95% (95% CI: 89-98%). Progression-free survival (PFS) in the overall population at 24 months was 70% (95% CI: 60%-79%). In the primary hFSRT group, PFS was significantly lower with the most hypofractionated schedules of 21-23 Gy in 3 fractions vs. 25-40 Gy in 5-10 fractions: 62% vs. 92% (p = 0.0006). The incidence of radionecrosis at 24 months was significantly lower in the primary hFSRT group, at 2% vs. 20% in the re-irradiation hFSRT group (p = 0.002).
我们评估了立体定向放射治疗（hFSRT）在颅内脑膜瘤治疗中的疗效和耐受性。2008 年 12 月至 2016 年 6 月，126 例 136 例颅内脑膜瘤患者接受机器人 hFSRT 治疗。hFSRT 可作为原发性放疗，也可作为放疗后局部复发的挽救治疗。中位处方剂量为 25Gy（12-40），中位分割次数为 5（3-10）。中位随访 20.3 个月（1-77 个月）后，原发性 hFSRT 组 24 个月局部控制率（LC）为 81%，再放疗组为 39%（p=0.002）。总体人群症状的临床控制率为 95%（95%可信区间：89-98%）。总体人群 24 个月无进展生存率（PFS）为 70%（95%可信区间：60%-79%）。在原发性 hFSRT 组，21-23Gy/3 次的最适分次方案的 PFS 明显低于 25-40Gy/5-10 次的方案：62%比 92%（p=0.0006）。24 个月时，原发性 hFSRT 组放射性坏死的发生率明显低于再放疗 hFSRT 组，分别为 2%和 20%（p=0.002）。
