Radiotherapy in the treatment of benign meningioma of the skull base

Object. This study was undertaken to assess the long-term efficacy and toxi city of conventional fractionated external-beam radiation in the treatment of benign skull base meningioma. Methods. This is a retrospective study of 82 patients with histologically v erified benign skull base meningioma treated by surgery followed by fractio nated external-beam radiation at the Royal Marsden Hospital between 1962 an d 1992. The 5- and 10-year progression-free survival (PFS) rates were 92% a nd 83%, respectively, with the site of disease being the only independent p rognostic factor for tumor control according to multivariate analysis. The 10-year PFS rate for patients with sphenoid ridge meningiomas was 69% compa red with 90% for those with tumors in the parasellar region. The overall IO -year survival rate was 71%, with performance status and patient age found to be significant independent prognostic factors. Six patients had worsenin g vision, which was due to cataract in five cases and retinopathy in one. T here were no recorded cases of cranial nerve neuropathy. Conclusions. The excellent long-term tumor control and length of survival w ith minimal toxicity associated with conventional external-beam radiation s hould serve as a baseline for evaluation of new treatment strategies such a s radiosurgery and skull base surgery.