Postoperative radiotherapy for meningiomas – a decision-making analysis
Abstract Background The management of meningiomas is challenging, and the role of postoperative radiotherapy is not standardized. Methods Radiation oncology experts in Swiss centres were asked to participate in this decision-making analysis on the use of postoperative radiotherapy (RT) for meningiom...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-09607-z |
| _version_ | 1828785417632088064 |
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| author | Galina Farina Fischer Detlef Brügge Nicolaus Andratschke Brigitta Gertrud Baumert Davide Giovanni Bosetti Francesca Caparrotti Evelyn Herrmann Alexandros Papachristofilou Susanne Rogers Lucia Schwyzer Daniel Rudolf Zwahlen Thomas Hundsberger Paul Martin Putora |
| author_facet | Galina Farina Fischer Detlef Brügge Nicolaus Andratschke Brigitta Gertrud Baumert Davide Giovanni Bosetti Francesca Caparrotti Evelyn Herrmann Alexandros Papachristofilou Susanne Rogers Lucia Schwyzer Daniel Rudolf Zwahlen Thomas Hundsberger Paul Martin Putora |
| author_sort | Galina Farina Fischer |
| collection | DOAJ |
| description | Abstract Background The management of meningiomas is challenging, and the role of postoperative radiotherapy is not standardized. Methods Radiation oncology experts in Swiss centres were asked to participate in this decision-making analysis on the use of postoperative radiotherapy (RT) for meningiomas. Experts from ten Swiss centres agreed to participate and provided their treatment algorithms. Their input was converted into decision trees based on the objective consensus methodology. The decision trees were used as a basis to identify consensus and discrepancies in clinical routine. Results Several criteria used for decision-making in postoperative RT in meningiomas were identified: histological grading, resection status, recurrence, location of the tumour, zugzwang (therapeutic need to treat and/or severity of symptoms), size, and cell division rate. Postoperative RT is recommended by all experts for WHO grade III tumours as well as for incompletely resected WHO grade II tumours. While most centres do not recommend adjuvant irradiation for WHO grade I meningiomas, some offer this treatment in recurrent situations or routinely for symptomatic tumours in critical locations. The recommendations for postoperative RT for recurrent or incompletely resected WHO grade I and II meningiomas were surprisingly heterogeneous. Conclusions Due to limited evidence on the utility of postoperative RT for meningiomas, treatment strategies vary considerably among clinical experts depending on the clinical setting, even in a small country like Switzerland. Clear majorities were identified for postoperative RT in WHO grade III meningiomas and against RT for hemispheric grade I meningiomas outside critical locations. The limited data and variations in clinical recommendations are in contrast with the high prevalence of meningiomas, especially in elderly individuals. |
| first_indexed | 2024-12-11T23:50:47Z |
| format | Article |
| id | doaj.art-20324a9e4308465fb8e7b9b19d6e3f80 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-11T23:50:47Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-20324a9e4308465fb8e7b9b19d6e3f802022-12-22T00:45:29ZengBMCBMC Cancer1471-24072022-05-0122111010.1186/s12885-022-09607-zPostoperative radiotherapy for meningiomas – a decision-making analysisGalina Farina Fischer0Detlef Brügge1Nicolaus Andratschke2Brigitta Gertrud Baumert3Davide Giovanni Bosetti4Francesca Caparrotti5Evelyn Herrmann6Alexandros Papachristofilou7Susanne Rogers8Lucia Schwyzer9Daniel Rudolf Zwahlen10Thomas Hundsberger11Paul Martin Putora12Department of Radiation Oncology, Kantonsspital St. GallenDepartment of Radiation Oncology, Kantonsspital St. GallenDepartment of Radiation Oncology, University Hospital of Zurich, University of ZurichInstitute of Radiation Oncology, Cantonal Hospital GraubündenClinic of Radiation Oncology, Oncology Institute of Southern SwitzerlandDepartment of Radiation Oncology, University Hospital GenevaDepartment of Radiation Oncology, University of BernDepartment of Radiation Oncology, University Hospital BaselRadiation Oncology Centre KSA-KSB, Kantonsspital AarauDepartment of Neurosurgery, Kantonsspital AarauDepartment of Radiation Oncology, Kantonsspital WinterthurDepartment of Neurology, Cantonal Hospital St. GallenDepartment of Radiation Oncology, Kantonsspital St. GallenAbstract Background The management of meningiomas is challenging, and the role of postoperative radiotherapy is not standardized. Methods Radiation oncology experts in Swiss centres were asked to participate in this decision-making analysis on the use of postoperative radiotherapy (RT) for meningiomas. Experts from ten Swiss centres agreed to participate and provided their treatment algorithms. Their input was converted into decision trees based on the objective consensus methodology. The decision trees were used as a basis to identify consensus and discrepancies in clinical routine. Results Several criteria used for decision-making in postoperative RT in meningiomas were identified: histological grading, resection status, recurrence, location of the tumour, zugzwang (therapeutic need to treat and/or severity of symptoms), size, and cell division rate. Postoperative RT is recommended by all experts for WHO grade III tumours as well as for incompletely resected WHO grade II tumours. While most centres do not recommend adjuvant irradiation for WHO grade I meningiomas, some offer this treatment in recurrent situations or routinely for symptomatic tumours in critical locations. The recommendations for postoperative RT for recurrent or incompletely resected WHO grade I and II meningiomas were surprisingly heterogeneous. Conclusions Due to limited evidence on the utility of postoperative RT for meningiomas, treatment strategies vary considerably among clinical experts depending on the clinical setting, even in a small country like Switzerland. Clear majorities were identified for postoperative RT in WHO grade III meningiomas and against RT for hemispheric grade I meningiomas outside critical locations. The limited data and variations in clinical recommendations are in contrast with the high prevalence of meningiomas, especially in elderly individuals.https://doi.org/10.1186/s12885-022-09607-zMeningiomaRadiotherapyAdjuvantPostoperativeDecision-makingSRS |
| spellingShingle | Galina Farina Fischer Detlef Brügge Nicolaus Andratschke Brigitta Gertrud Baumert Davide Giovanni Bosetti Francesca Caparrotti Evelyn Herrmann Alexandros Papachristofilou Susanne Rogers Lucia Schwyzer Daniel Rudolf Zwahlen Thomas Hundsberger Paul Martin Putora Postoperative radiotherapy for meningiomas – a decision-making analysis BMC Cancer Meningioma Radiotherapy Adjuvant Postoperative Decision-making SRS |
| title | Postoperative radiotherapy for meningiomas – a decision-making analysis |
| title_full | Postoperative radiotherapy for meningiomas – a decision-making analysis |
| title_fullStr | Postoperative radiotherapy for meningiomas – a decision-making analysis |
| title_full_unstemmed | Postoperative radiotherapy for meningiomas – a decision-making analysis |
| title_short | Postoperative radiotherapy for meningiomas – a decision-making analysis |
| title_sort | postoperative radiotherapy for meningiomas a decision making analysis |
| topic | Meningioma Radiotherapy Adjuvant Postoperative Decision-making SRS |
| url | https://doi.org/10.1186/s12885-022-09607-z |
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