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Fractionated Stereotactic Radiotherapy (FSRT) versus CyberKnife-Based hypofractionation in skull base meningioma
EANS Academy. Conti A. 09/26/19; 276072; EP04020
Assoc. Prof. Alfredo Conti
Assoc. Prof. Alfredo Conti

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Abstract
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Background: It was the aim of this retrospective german-italian multicentre analysis to compare the role of normofractionated stereotactic radiotherapy (nFSRT) to CyberKnife based hypofractionated stereotactic radiotherapy (CK-hFSRT) for skull base meningioma
Methods: 341 patients from three centers were treated with either nFSRT or CK-hFSRT for skull base meningioma. Treatment planning was based on CT and MRI following institutional guidelines. Most nFSRT received 33x1.8Gy and MOST CK-hFSRT patients received 5x5Gy. The median follow-up time was 36 months (1 - 232 months).
Results: In the CK-hFSRT group local control (LC) was 99.4% at 12 months, 96.8% at three years and 80.3% at 10 years. In the nFSRT group LC was 100% at 12 months, 99% at 36 months and 79.1% at 10 years. There was no significant difference in LC-rates between the nFSRT group and the CK-hFSRT group (p=0.56, HR=0.76 [95% CI, 0.3 - 1.9]). No acute or chronic severe toxicity (CTCAE 4.0 3) was seen in the CK-hFSRT collective. In the nFSRT collective one case (0.74%) of acute grade III toxicity was seen and two cases (1.47%) of severe chronic toxicity were seen.
Conclusion: This analysis of pooled data from three centers shows excellent local control and low rates of side effects for patients treated with CK-hFSRT and nFSRT. The efficacy and safety as well as the convenience for the patient is a strong argument for the use of CK-hFSRT in patients suffering from skull base meningioma.
Background: It was the aim of this retrospective german-italian multicentre analysis to compare the role of normofractionated stereotactic radiotherapy (nFSRT) to CyberKnife based hypofractionated stereotactic radiotherapy (CK-hFSRT) for skull base meningioma
Methods: 341 patients from three centers were treated with either nFSRT or CK-hFSRT for skull base meningioma. Treatment planning was based on CT and MRI following institutional guidelines. Most nFSRT received 33x1.8Gy and MOST CK-hFSRT patients received 5x5Gy. The median follow-up time was 36 months (1 - 232 months).
Results: In the CK-hFSRT group local control (LC) was 99.4% at 12 months, 96.8% at three years and 80.3% at 10 years. In the nFSRT group LC was 100% at 12 months, 99% at 36 months and 79.1% at 10 years. There was no significant difference in LC-rates between the nFSRT group and the CK-hFSRT group (p=0.56, HR=0.76 [95% CI, 0.3 - 1.9]). No acute or chronic severe toxicity (CTCAE 4.0 3) was seen in the CK-hFSRT collective. In the nFSRT collective one case (0.74%) of acute grade III toxicity was seen and two cases (1.47%) of severe chronic toxicity were seen.
Conclusion: This analysis of pooled data from three centers shows excellent local control and low rates of side effects for patients treated with CK-hFSRT and nFSRT. The efficacy and safety as well as the convenience for the patient is a strong argument for the use of CK-hFSRT in patients suffering from skull base meningioma.
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