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Efficacy and toxicity of bimodal radiotherapy in WHO grade 2 meningiomas following subtotal resection with carbon ion boost:Prospective phase 2 MARCIE trial

Authors :
Deng, Maximilian Y.
Maas, Sybren L.N.
Hinz, Felix
Karger, Christian P.
Sievers, Philipp
Eichkorn, Tanja
Meixner, Eva
Hoegen-Sassmannshausen, Philipp
Hörner-Rieber, Juliane
Lischalk, Jonathan W.
Seidensaal, Katharina
Bernhardt, Denise
Jungk, Christine
Unterberg, Andreas
Wick, Antje
Wick, Wolfgang
Deimling, Andreas von
Sahm, Felix
Combs, Stephanie
Herfarth, Klaus
Debus, Jürgen
König, Laila
Deng, Maximilian Y.
Maas, Sybren L.N.
Hinz, Felix
Karger, Christian P.
Sievers, Philipp
Eichkorn, Tanja
Meixner, Eva
Hoegen-Sassmannshausen, Philipp
Hörner-Rieber, Juliane
Lischalk, Jonathan W.
Seidensaal, Katharina
Bernhardt, Denise
Jungk, Christine
Unterberg, Andreas
Wick, Antje
Wick, Wolfgang
Deimling, Andreas von
Sahm, Felix
Combs, Stephanie
Herfarth, Klaus
Debus, Jürgen
König, Laila
Source :
Deng , M Y , Maas , S L N , Hinz , F , Karger , C P , Sievers , P , Eichkorn , T , Meixner , E , Hoegen-Sassmannshausen , P , Hörner-Rieber , J , Lischalk , J W , Seidensaal , K , Bernhardt , D , Jungk , C , Unterberg , A , Wick , A , Wick , W , Deimling , A V , Sahm , F , Combs , S , Herfarth , K , Debus , J & König , L 2024 , ' Efficacy and toxicity of bimodal radiotherapy in WHO grade 2 meningiomas following subtotal resection with carbon ion boost : Prospective phase 2 MARCIE trial ' , Neuro-Oncology , vol. 26 , no. 4 , pp. 701-712 .
Publication Year :
2024

Abstract

Background: Novel radiotherapeutic modalities using carbon ions provide an increased relative biological effectiveness (RBE) compared to photons, delivering a higher biological dose while reducing radiation exposure for adjacent organs. This prospective phase 2 trial investigated bimodal radiotherapy using photons with carbon-ion (C12)-boost in patients with WHO grade 2 meningiomas following subtotal resection (Simpson grade 4 or 5).Methods:A total of 33 patients were enrolled from July 2012 until July 2020. The study treatment comprised a C12-boost (18 Gy [RBE] in 6 fractions) applied to the macroscopic tumor in combination with photon radiotherapy (50 Gy in 25 fractions). The primary endpoint was the 3-year progression-free survival (PFS), and the secondary endpoints included overall survival, safety and treatment toxicities. Results:With a median follow-up of 42 months, the 3-year estimates of PFS, local PFS and overall survival were 80.3%, 86.7%, and 89.8%, respectively. Radiation-induced contrast enhancement (RICE) was encountered in 45%, particularly in patients with periventricularly located meningiomas. Patients exhibiting RICE were mostly either asymptomatic (40%) or presented immediate neurological and radiological improvement (47%) after the administration of corticosteroids or bevacizumab in case of radiation necrosis (3/33). Treatment-associated complications occurred in 1 patient with radiation necrosis who died due to postoperative complications after resection of radiation necrosis. The study was prematurely terminated after recruiting 33 of the planned 40 patients. Conclusions:Our study demonstrates a bimodal approach utilizing photons with C12-boost may achieve a superior local PFS to conventional photon RT, but must be balanced against the potential risks of toxicities.

Details

Database :
OAIster
Journal :
Deng , M Y , Maas , S L N , Hinz , F , Karger , C P , Sievers , P , Eichkorn , T , Meixner , E , Hoegen-Sassmannshausen , P , Hörner-Rieber , J , Lischalk , J W , Seidensaal , K , Bernhardt , D , Jungk , C , Unterberg , A , Wick , A , Wick , W , Deimling , A V , Sahm , F , Combs , S , Herfarth , K , Debus , J & König , L 2024 , ' Efficacy and toxicity of bimodal radiotherapy in WHO grade 2 meningiomas following subtotal resection with carbon ion boost : Prospective phase 2 MARCIE trial ' , Neuro-Oncology , vol. 26 , no. 4 , pp. 701-712 .
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1434546391
Document Type :
Electronic Resource