American journal of clinical oncology · 2025
Lack of Impact of Expansion Size From Gross Tumor Volume to Planning Target Volume on Control Rates and Patterns of Recurrence in Fractionated Radiotherapy for WHO Grade 1 Meningiomas.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Weil Christopher R, Rock Calvin B, Sarkar Vikren, Gravbrot Nicholas, Lew Felicia H, Rock Christian B, Burt Lindsay M, DeCesaris Cristina M, Jensen Randy L, Shrieve Dennis C, Cannon Donald M
Аннотация
OBJECTIVES: For single-fraction stereotactic radiosurgery (SRS) for WHO grade I meningiomas, no-GTV or minimal-GTV to PTV margin is an accepted practice. We evaluated whether there is a control difference based on GTV to PTV expansion size for fractionated RT.
METHODS: Eighty-seven patients with WHO grade 1 meningioma were identified from an institutional database, treated with either conventional immobilization and radiation treatment delivery techniques (cRT) with 5 to 20 mm PTV expansions or fractionated stereotactic radiotherapy (fSRT) with ≤3 mm GTV to PTV expansions. Kaplan-Meier estimators were used for local failure-free survival (LFFS), marginal-failure-free survival (MFFS), and distant failure-free survival (DFFS) analysis.
RESULTS: The median follow-up duration was 9.0 years. Twenty-five patients (29%) received cRT and 62 patients (71%) received fSRT. The median dose was 54 Gray. There were 4 local (5%), 1 marginal (1%), and 1 distant failure (1%). The fSRT and cRT groups each had 2 local failures; 3/4 local failures occurred in areas near critical organs at risk. For cRT versus fSRT, 5-year and 10-year LFFS were 100% versus 98% ( P =0.46) and 94% versus 96% ( P =0.34), 5-year and 10-year MFFS were 100% versus 100% and 100% versus 92% ( P =0.004), and 5-year and 10-year DFFS were 100% versus 98% at both time points ( P =0.65 and P =0.67, respectively).
CONCLUSIONS: In this patient cohort, there was no local control benefit for larger GTV-to-PTV expansions. For patients with tumors not eligible for SRS, fractionated stereotactic treatment workflow with ≤3 mm PTV expansions is an effective approach for WHO grade 1 meningiomas.
METHODS: Eighty-seven patients with WHO grade 1 meningioma were identified from an institutional database, treated with either conventional immobilization and radiation treatment delivery techniques (cRT) with 5 to 20 mm PTV expansions or fractionated stereotactic radiotherapy (fSRT) with ≤3 mm GTV to PTV expansions. Kaplan-Meier estimators were used for local failure-free survival (LFFS), marginal-failure-free survival (MFFS), and distant failure-free survival (DFFS) analysis.
RESULTS: The median follow-up duration was 9.0 years. Twenty-five patients (29%) received cRT and 62 patients (71%) received fSRT. The median dose was 54 Gray. There were 4 local (5%), 1 marginal (1%), and 1 distant failure (1%). The fSRT and cRT groups each had 2 local failures; 3/4 local failures occurred in areas near critical organs at risk. For cRT versus fSRT, 5-year and 10-year LFFS were 100% versus 98% ( P =0.46) and 94% versus 96% ( P =0.34), 5-year and 10-year MFFS were 100% versus 100% and 100% versus 92% ( P =0.004), and 5-year and 10-year DFFS were 100% versus 98% at both time points ( P =0.65 and P =0.67, respectively).
CONCLUSIONS: In this patient cohort, there was no local control benefit for larger GTV-to-PTV expansions. For patients with tumors not eligible for SRS, fractionated stereotactic treatment workflow with ≤3 mm PTV expansions is an effective approach for WHO grade 1 meningiomas.