Long-term results of multimodal peptide receptor radionuclide therapy and fractionated external beam radiotherapy for treatment of advanced symptomatic meningioma
Philipp E. Hartrampf, Heribert Hänscheid, Olivia Kertels, Andreas Schirbel, Michael C. Kreißl, Michael Flentje, Reinhart A. Sweeney, Andreas K. Buck, Bülent Polat, Constantin Lapa
Abstract
BACKGROUND: The combination of somatostatin receptor-directed peptide receptor radionuclide therapy (PRRT) in combination with external beam radiotherapy (EBRT) might prove a feasible treatment option in patients with advanced meningioma. PATIENTS AND METHODS: From May 2010 to May 2011, 10 patients with unresectable meningioma (6 × WHO grade I, 2 × WHO grade II, 2 × WHO grading not available) were treated with one cycle of PRRT followed by EBRT. Long-term toxicity and efficacy were assessed according to Common Terminology Criteria for Adverse Events version 5.0 and magnetic resonance imaging-based Response Assessment in Neuro-Oncology Working Group criteria, respectively. RESULTS: During long-term follow-up of a median of 105.0 months (range, 38.2-111.4 m), combined PRRT and EBRT was well-tolerated with no severe acute or chronic toxicity. Kidney or bone marrow function was not affected in any patient. Combination of PRRT and EBRT resulted in disease stabilization in 7 of the 10 patients with a median progression-free survival of 107.7 months (range, 47.2-111.4 m) vs. 26.2 months (range, 13.8-75.9 m) for the patients with meningioma progression. CONCLUSIONS: The combination of PRRT and EBRT is a feasible and safe therapeutic option in meningioma patients. In this pilot cohort, the multimodality treatment demonstrated good disease stabilization.