Article
Stereotactic radiosurgery of benign brain tumors in elderly patients – evaluation of clinical outcome and toxicity
Stereotaktische Radiochirurgie von gutartigen Hirntumoren bei älteren Patienten – Evaluation von klinischem Outcome und Toxizität
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Published: | May 8, 2019 |
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Objective: Stereotactic radiosurgery (SRS) is widely accepted as a therapeutic option for benign brain tumors such as meningioma and neurinoma; however, the detailed data on outcomes and toxicity in elderly patients remain unclear.
Methods: In this single center retrospective analysis we consecutively included all patients above or equal to 60 years with benign tumors (meningiomas, schwannomas) who underwent single fraction SRS by use of modified linear accelerator (LINAC) or Cyberknife® between 1991 and 2018. Patient data were analyzed in terms of tumor control, symptom control (stable clinical condition), co-morbidities and incidence of early and late treatment related complications (rated by using the Common Terminology Criteria for Adverse Events, CTCAE; v4.03).
Results: We identified 343 patients with either vestibular schwannoma (n=168) or meningioma (n=188). The median age was 68 yr (range, 60–86 yr) and median follow-up was 34 months (range, 2–236 mo). About 30% (n=103) of the patients were followed for more than 60 months. Tumor margins were irradiated with a median dose of 12 Gy, and the median tumor volume was 2.7 ml (range, 0.1–28 ml).
Actuarial local tumor control rates at 2, 5, and 10 yr after SRS were 98%, 93%, and 90%, respectively. Mild or moderate adverse events were noted in 34 patients (9.9%). No severe adverse event was observed.
Conclusion: SRS provides favorable tumor control and a low risk of adverse events including minimum invasiveness. Thus, SRS should be taken into account as standard therapy for benign tumors in elderly patients.