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J Neurol Surg B Skull Base 2022; 83(04): 418-422
DOI: 10.1055/s-0041-1735879
Original Article

Adjuvant Radiotherapy in Grade II, Atypical Meningioma of the Skull Base

David P. Bray 
1   Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, United States
,
Bryan E. Buster
1   Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, United States
,
Joseph W. Quillin
1   Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, United States
,
Robert H. Press
2   New York Proton Center, New York, United States
,
Bree R. Eaton
3   Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia, United States
,
Jeffrey J. Olson
1   Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, United States
› Author Affiliations Funding D.P.B. is partially supported by the Nell W. and William S. Elkin Research Fellowship in Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, Georgia, United States.
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Abstract

Introduction Atypical meningiomas (AM) are meningiomas that are more aggressive than their grade-I counterparts and have a higher rate of recurrence. The effect of adjuvant radiotherapy (ART) on AM of the skull base is not defined.

Methods A retrospective review of all AM's of the skull base primarily resected at our institution from 1996 to 2018 was completed. ART was defined as radiotherapy (RT) that occurred within 6 months of initial resection, regardless of Simpson's grade. Minimum time length of follow-up after resection was 2 years. Statistical analysis was performed using SAS.

Results There were a total of 59 skull base–located (SBL) AMs resected at our institution from 1996 to 2018. The average age of our cohort was 53.2 years. Gross total resection, defined as Simpson's grades I to III resection, was achieved in 36 (61%) of cases. Thirty-five of 59 (59%) patients received ART. Recurrence was observed in 14 patients (24%), and mean time to recurrence was 63.8 months. Patients who received ART had a lower observed rate of recurrence (8 vs. 46%); however, time to recurrence was not significantly different between the two populations.

Conclusion We observe that AM in the skull base location have higher recurrence rates than we would expect from grade-I meningioma. These data suggest that ART may offer benefit to the overall observed frequency of recurrence of SBL AM; however, the time to recurrence between patients who received ART and those who did not was not statistically significant in survival analysis.

Keywords

atypical meningioma - radiotherapy - skull base - meningioma


Publication History

Received: 13 June 2021

Accepted: 12 August 2021

Article published online:
21 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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