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Stereotactic Radiosurgery Compared With Active Surveillance for Asymptomatic, Parafalcine, and Parasagittal Meningiomas: A Matched Cohort Analysis From the IMPASSE Study
S. Pikis, G. Mantziaris, A. Bunevicius, AI. Islim, S. Peker, Y. Samanci, AM. Nabeel, WA. Reda, SR. Tawadros, AMN. El-Shehaby, K. Abdelkarim, RM. Emad, V. Delabar, D. Mathieu, CC. Lee, HC. Yang, R. Liscak, J. May, RM. Alvarez, DN. Patel, D....
Language English Country United States
Document type Journal Article
Persistent link
https://www.medvik.cz/link/bmc22018246
- MeSH
- Cohort Studies MeSH
- Humans MeSH
- Meningeal Neoplasms * epidemiology radiotherapy MeSH
- Meningioma * diagnostic imaging epidemiology radiotherapy MeSH
- Follow-Up Studies MeSH
- Watchful Waiting MeSH
- Radiosurgery * adverse effects methods MeSH
- Retrospective Studies MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: The optimal management of asymptomatic, presumed WHO grade I meningiomas remains controversial. OBJECTIVE: To define the safety and efficacy of stereotactic radiosurgery (SRS) compared with active surveillance for the management of patients with asymptomatic parafalcine/parasagittal (PFPS) meningiomas. METHODS: Data from SRS-treated patients from 14 centers and patients managed conservatively for an asymptomatic, PFPS meningioma were compared. Local tumor control rate and new neurological deficits development were evaluated in the active surveillance and the SRS-treated cohorts. RESULTS: There were 173 SRS-treated patients and 98 patients managed conservatively in the unmatched cohorts. After matching for patient age and tumor volume, there were 98 patients in each cohort. The median radiological follow-up period was 43 months for the SRS cohort and 36 months for the active surveillance cohort (P = .04). The median clinical follow-up for the SRS and active surveillance cohorts were 44 and 36 months, respectively. Meningioma control was noted in all SRS-treated patients and in 61.2% of patients managed with active surveillance (P < .001). SRS-related neurological deficits occurred in 3.1% of the patients (n = 3), which were all transient. In the active surveillance cohort, 2% of patients (n = 2) developed neurological symptoms because of tumor progression (P = 1.0), resulting in death of 1 patient (1%). CONCLUSION: Up-front SRS affords superior radiological PFPS meningioma control as compared with active surveillance and may lower the risk of meningioma-related permanent neurological deficit and/or death.
Ain Shams University Cairo Egypt
Department of Neurological Surgery University of Virginia Charlottesville Virginia USA
Department of Neurosurgery Benha University Benha Egypt
Department of Neurosurgery Koc University School of Medicine Istanbul Turkey
Department of Neurosurgery New York University New York New York USA
Department of Neurosurgery University of Alberta Edmonton Alberta Canada
Department of Neurosurgery University of Miami Miller School of Medicine Miami Florida USA
Department of Neurosurgery University of Pittsburgh Pittsburgh Pennsylvania USA
Department of Radiation and Stereotactic Neurosurgery Na Homolce Hospital Prague Czech Republic
Department of Radiation Oncology National Cancer Institute Cairo University Cairo Egypt
Department of Radiation Oncology New York University New York New York USA
Department of Radiology Dominican Gamma Knife Center and CEDIMAT Santo Domingo Dominican Republic
Department of Radiosurgery Rúber International Hospital Madrid Spain
Gamma Knife Center Cairo Nasser Institute Benha University Benha Egypt
References provided by Crossref.org
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