How safe and effective is irradiating radiation-induced meningiomas? Single-center experience in primary and salvage Gamma-Knife Radiosurgery, systematic review, and metanalysis of current evidence on the topic

Filippo Gagliardi; Pierfrancesco De Domenico; Silvia Snider; Riccardo Calcagnile; Francesca Roncelli; Lina Raffaella Barzaghi; Pietro Mortini

doi:10.1016/j.critrevonc.2024.104526

How safe and effective is irradiating radiation-induced meningiomas? Single-center experience in primary and salvage Gamma-Knife Radiosurgery, systematic review, and metanalysis of current evidence on the topic

Crit Rev Oncol Hematol. 2024 Oct 5:204:104526. doi: 10.1016/j.critrevonc.2024.104526. Online ahead of print.

Authors

Filippo Gagliardi¹, Pierfrancesco De Domenico², Silvia Snider¹, Riccardo Calcagnile¹, Francesca Roncelli¹, Lina Raffaella Barzaghi¹, Pietro Mortini¹

Affiliations

¹ IRCCS San Raffaele Scientific Institute, Department of Neurosurgery and Gamma Knife Radiosurgery, Milan 20132, Italy.
² IRCCS San Raffaele Scientific Institute, Department of Neurosurgery and Gamma Knife Radiosurgery, Milan 20132, Italy. Electronic address: dedomenico.pierfrancesco@hsr.it.

PMID: 39370060
DOI: 10.1016/j.critrevonc.2024.104526

Abstract

This is a single-center experience and metanalysis of the safety and efficacy measures of Gamma-knife stereotactic radiosurgery (SRS-GK) for radiation-induced meningiomas (RIMs). This study comprised a single-center analysis of SRS-GK for RIMs at IRCCS San Raffaele Hospital, Milan, Italy, and a systematic literature review and meta-analysis to address the actuarial local control (LC), distant control (DC), progression-free survival (PFS), and toxicity. The original series comprised 13 patients harboring 30 RIMs. Partial response was observed in 26 %, stability in 52 %, and progression in 22 %. The 5-year LC and DC rates were 71 % and 67 %. One patient developed radionecrosis, and an additional 2 presented edema. Metanalysis comprised 4 papers and data from the original series, comprising 146 patients and 308 RIMs. The 5-year LC was 84 %, the DC 67 %, and radionecrosis in 1.4 %. SRS-GK has an efficacy profile falling between that observed for radiologically suspected sporadic meningiomas and confirmed higher-grade lesions.

Keywords: Gamma-Knife; Meningiomas; Metanalysis; Radiation-induced meningiomas; Stereotactic radiosurgery.

Publication types

Review