(P044) Treatment Outcomes of WHO Grade III Malignant Meningioma With and Without Postoperative Radiation Therapy

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

Our study showed that patients with primary malignant meningioma had better outcomes after maximal resection followed by postoperative radiation. In contrast, transformed meningiomas demonstrated more aggressive behavior, with lower median survival despite RT. Further multi-institutional or randomized studies are required to evaluate the effectiveness of postoperative RT to determine the best approach to managing these tumors.

Hanako Yamauchi Farol, DO, Michael R. Girvigian, MD, Michael J. Miller, MD, Joseph C. Chen, MD, Javad Rahimian, PhD, Christine Chang-Halpenny, MD, Brandon N. Glousman, Najeeb Alshak, MD, Kenneth Lodin, MD; UCI; Kaiser Permanente; USC

OBJECTIVE: Malignant meningioma is a rare disease, the optimal management of which is unclear. Our goal was to review our institution’s treatment and outcomes of World Health Organization (WHO) grade III malignant meningioma.

METHODS: From January 2000 to December 2011, through a retrospective chart review, we identified 16 patients with a pathologic diagnosis of WHO grade III meningioma; 11 of these patients had presented with primary malignant meningioma, and 5 presented after transformation into a malignant meningioma from earlier-grade disease.

RESULTS: Median follow-up was 20.5 months (range: 0.4–140 mo). All patients underwent surgical resection with or without radiation therapy (RT). Doses given ranged from 5,040 to 6,000 cGy. Of the 11 patients with primary malignant meningioma, 6 had gross total resection (GTR), 4 had subtotal resection (STR), and 1 had unknown status. RT was given to 6 of the 11 patients. Median survival was 88.2 months with RT and 8.7 months without RT (P = .022). Median time to progression was 48.1 months with RT and 5.1 months without RT (P = .045). Of the five patients with transformed meningioma, two received GTR and three had STR. RT was given to four of the five patients. Median survival for these five patients was 16.1 months, with median time to progression of 8.3 months. For all patients, overall survival (OS) and progression-free survival (PFS) rates were 68.8% and 56.3% at 1 year and 39.4% and 21.4% at 5 years, respectively. 

CONCLUSIONS: Our study showed that patients with primary malignant meningioma had better outcomes after maximal resection followed by postoperative radiation. In contrast, transformed meningiomas demonstrated more aggressive behavior, with lower median survival despite RT. Further multi-institutional or randomized studies are required to evaluate the effectiveness of postoperative RT to determine the best approach to managing these tumors.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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