OUTCOMES OF FRACTIONATED RADIOTHERAPY IN MENINGIOMA

Abstract AIMS Meningiomas are the most common primary brain tumour. Radiotherapy is indicated for primary and adjuvant treatment, or at recurrence. Fractionated radiotherapy is still commonly used for tumours that do not have a surgical option or where stereotactic radiosurgery (SRS) is not possible due to size or location. We audited the use of fractionated radiotherapy for the treatment of meningiomas at a single centre, between 2011-2024. METHODS Patients who received fractionated radiotherapy at the Royal Sussex County Hospital were identified from a patient database. Electronic patient records were used to collect treatment details, toxicity and outcomes. RESULTS Between Oct 2011 and Oct 2024, 36 patients received fractionated radiotherapy. The median patient age was 67.5 (range 46-84). Of the 28 patients who had histology available 12 (33%) were Grade 1, 15 (42%) Grade 2 and 1 (3%) Grade 3. 7 (19.4%) patients were treated with primary intent, 12 (33.3%) with adjuvant intent and 17 (47.2%) at recurrence. The patients treated at recurrence had between 1-3 prior surgeries, with 2 having received prior SRS. The dose of radiotherapy used was between 50-60 Gy depending on grade and intention. The most common toxicities were headache and fatigue. Of the 34 patients who had notes from during their radiotherapy, 28 had grade 1-2 toxicity and 1 had grade 3 toxicity (otitis media). The mean overall survival (OS) was 91.8 months with a standard error of 9.8 months. The mean progression free survival (PFS) was 57.7 months with a standard error of 9.1 months. CONCLUSION Although this represents a cohort of patients unsuitable for SRS or surgery, fractionated radiotherapy was gen- erally well tolerated and effective, and outcomes were consistent with other published case series.