%0 Journal Article
%T Proton therapy for intracranial meningioma: a single-institution retrospective analysis of efficacy, survival and toxicity outcomes.
%A Iannalfi A
%A Riva G
%A Lillo S
%A Ciccone L
%A Fontana G
%A Molinelli S
%A Trombetta L
%A Ciocca M
%A Imparato S
%A Pecorilla M
%A Orlandi E
%J J Neurooncol
%V 0
%N 0
%D 2024 Jun 25
%M 38918319
%F 4.506
%R 10.1007/s11060-024-04751-x
%X <B>OBJECTIVE: </B>To report the outcomes of a large series of intracranial meningiomas (IMs) submitted to proton therapy (PT) with curative intent.<BR><B>METHODS: </B>We conducted a retrospective analysis on all consecutive IM patients treated between 2014 and 2021. The median PT prescription dose was 55.8 Gy relative biological effectiveness (RBE) and 66 GyRBE for benign/radiologically diagnosed and atypical/anaplastic IMs, respectively. Local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), overall survival (OS), and radionecrosis-free survival (RNFS) were evaluated with the Kaplan-Meier method. Univariable analysis was performed to identify potential prognostic factors for clinical outcomes. Toxicity was reported according to the latest Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.<BR><B>RESULTS: </B>Overall, 167 patients were included. With a median follow-up of 41 months (range, 6-99), twelve patients (7%) developed tumor local recurrence after a median time of 39 months. The 5-year LRFS was 88% for the entire cohort, with a significant difference between benign/radiologically diagnosed and atypical/anaplastic IMs (98% vs. 47%, p < 0.001); this significant difference was maintained also for the 5-year OS and the 5-year DRFS rates. Patients aged ≤ 56 years reported significantly better outcomes, whereas lower prescription doses and skull base location were associated with better RNFS rates. Two patients experienced G3 acute toxicities (1.2%), and three patients G3 late toxicities (1.8%). There were no G4-G5 adverse events.<BR><B>CONCLUSIONS: </B>PT proved to be effective with an acceptable toxicity profile. To the best of our knowledge this is one of the largest series including IM patients submitted to PT.