Work

Radiotherapy for World Health Organization Grade 1 and 2 Intracranial Meningiomas: A Retrospective Analysis of Efficacy

Year: 2025

Type: article

Abstract: To evaluate the efficacy of radiotherapy (RT) for WHO grade 1 and 2 intracranial meningiomas, focusing on the impact of post-surgical tumor volume on treatment outcomes. Adult patients (≥18 years) with WHO grade 1 or 2 intracranial meningiomas who received RT between January 1, 2019, and April 1, 2022, were identified. Exclusion criteria encompassed known extracranial tumors, preoperative radio- or chemotherapy, and insufficient RT modality data. Patients were treated according to the international guidelines. Tumor recurrence was identified on MRI with a follow-up period until April 2024. Kaplan-Meier estimates for progression-free survival (PFS) calculations and Cox proportional hazard models were performed to evaluate the impact of tumor volume and other covariates on PFS. Among 113 patients with intracranial meningiomas who received RT, 103 met the inclusion criteria. Of these, 84.5% received photon-based and 15.5% proton-based treatment. The cohort was predominantly female (72.8%) with a mean age of 59 years. The 2-year and 5-year PFS rates were 95.6% and 90% for grade 1 tumors, respectively, and 83.3% for grade 2 tumors. Tumors >21 cm 3 post-surgical pre-RT had a significantly higher risk of progression (HR = 4.35, p = 0.006). Tumor volume was identified as a key prognostic factor for PFS in WHO grade 1 and 2 intracranial meningiomas treated with RT. A critical post-surgical volume threshold of 21 cm 3 significantly influences 2-year and 5-year PFS rates, with patients exceeding this threshold experiencing a 335% increase in risk of progression.

Source: World Neurosurgery

DOI: 10.1016/j.wneu.2025.123858