{ "labelLang" : "hun", "responseDate" : "2024-03-29 01:32", "content" : { "otype" : "JournalArticle", "mtid" : 30981187, "status" : "VALIDATED", "published" : true, "comment" : "Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri, United States \n Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri, United States \n Department of Neurosurgery, Washington University School of Medicine, St Louis, Missouri, United States \n Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, United States \n Cited By :10 \n Export Date: 9 May 2023 \n CODEN: IOBPD \n Correspondence Address: Huang, J.; Department of Radiation Oncology, 4921 Parkview Place, Campus, Box #8224, United States; email: jiayi.huang@wustl.edu \n Chemicals/CAS: bevacizumab, 216974-75-3, 1438851-35-4; dexamethasone, 50-02-2; octreotide, 83150-76-9, 1607842-55-6; temsirolimus, 162635-04-3, 343261-52-9 \n Manufacturers: Elekta, United States; Varian, United States \n Funding text 1: The current study includes data from the Washington University subset of the IMRIS Multicenter intraoperative magnetic imaging Neurosurgery Database (I-MiND). I-MiND is supported by an unrestricted educational grant from IMRIS, Inc, the manufacturer of an intraoperative magnetic resonance imaging (iMRI) device. 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"1", "firstPage" : "194", "lastPage" : "203", "firstPageOrInternalIdForSort" : "194", "pageLength" : 10, "publishedYear" : 2018, "abstractText" : "Purpose: To evaluate the clinical outcomes of reirradiation of recurrent meningiomas and factors related to patient selection and treatment modality.Methods and Materials: Recurrent meningioma patients who failed prior stereotactic radiosurgery (SRS) or fractionated external beam radiation therapy (EBRT) received reirradiation using either SRS or EBRT. Complete response (CR), partial response (PR), and progression after reirradiation were evaluated using the MacDonald criteria. Local control (LC), progression-free survival (PFS), and overall survival (OS) after reirradiation were analyzed using the Kaplan-Meier method. Logistic and Cox regression analyses were performed to identify factors associated with reirradiation modality and PFS, respectively.Results: Forty-three patients (14 grade 1/unknown, 29 grade 2/3) were reirradiated with SRS (67%) or EBRT (33%). Median time from initial SRS/EBRT to reirradiation was 60 months (range, 7.5-202); median tumor volume at the time of reirradiation was 4.8 cm(3) (range, 0.14-64). After a median radiologic follow-up of 19.4 months, the response rate (CR + PR) was 8% for grade 1 and 20% for grade 2/3 meningiomas. After 2 years, LC was 78%, PFS was 63%, and OS was 80%. Larger tumor volume and prior SRS were associated with reirradiation using EBRT. Reirradiated grade 2/3 meningiomas had significantly worse PFS than grade 1 (2-year PFS: 50% vs 92%, respectively; P =.02) but not LC (P =.11) or OS (P =.39). On multivariable analysis, worse PFS was significantly associated with grade 2/3 histology (hazard ratio, 3.92; 95% confidence interval, 1.33-11.6) as well as worse Karnofsky Performance Scale score but not reirradiation dose, volume, and modality. Grades 3 to 4 radiation necrosis developed in 4 patients (10%).Conclusions: Reirradiation of recurrent meningiomas appears to be feasible with promising clinical outcomes and an acceptable toxicity profile. (C) 2018 Elsevier Inc. 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