Results of radiotherapy for meningiomas with high risk for local recurrence: a retrospective analysis

Aim: Retrospective assessment of the efficacy of radiatiotherapy for mening eomas with high risk for local recurrence. Patients and Methods: Records of 67 patients with meningeomas treated from 1974 to 1995 at 2 centres were analyzed. Follow-up time ranged from 0.8 to 213 months (median: 61 months). Radiation therapy was given either after lo cal failure or after biopsy or subtotal resection. The ratio between malign ant (n = 20) and benign (n = 47) meningeoma was 1.2.4. Median age of the pa tients was 55 years (7 to 77 years). Radiation treatment was given at 1.5 t o 2 Gy per fraction to 36 to 79.5 Gy. Survival rates were calculated by the Kaplan-Meier method. Statistical comparisons were performed with the log-r ank test and the Cox proportional hazards model. The Bonferroni method was used to correct for multiple comparisons. Results: Five- and 10-year disease-free survival rates were 82% +/- 5% (sta ndard error) and 70% +/- 9%. Local control rates at 5 and 10 years were 78% +/- 5% and 68% +/- 9%. In uni- and multivariate analysis histology, sex, t otal dose add center showed no significant influence on the results. Patien ts age was significant for local control (univariate p = 0.02; multivariate p = 0.03) and disease-free survival (univariate/multivariate p = 0.04). Th e postoperative tumor burden had a significant influence of disease-free su rvival (multivariate p = 0.04). After Bonferroni correction no significant influence was observed. We did not observe late side effects, especially br ain necrosis. Conclusions: Despite of the negative selection of our patients we observed high survival- and local control rates after radiation therapy. This unders cores the role of radiation therapy in the treatment of meningeomas with hi gh risk of local failure.