Introduction: World Health Organization Grade 2 and 3 meningiomas have high recurrence rate; however, ambiguity remains around the role of radiation therapy as an adjunct to surgery for treatment. In this study, we aim to characterize the longitudinal impact of radiation therapy on progression free survival (PFS) and overall survival (OS).
Methods: Data were collected through retrospective chart reviews of meningioma cases operated at our center from 2016 to 2023, comparing two groups: surgery followed by stereotactic radiation (SRS+Sx) vs. surgery alone (Sx). Demographics, radiographic data, treatment modality, progression-free survival (PFS), and overall survival (OS) were calculated. Statistical analysis was conducted using SPSS v22.0, with Kaplan-Meier curves and log-rank tests, setting a significance threshold at p < 0.05.
Results: 63 patients with Grade 2 (89 %) and 3 (11 %) Meningiomas were selected for further analysis. 38% of patients received SRS + SX while 62 % only received Sx. PFS was calculated at 3 years, 5 years and 10 years. At the 3-year and 5-year, recurrence rates were significantly lower in SRS+Sx patients (0% at both intervals) compared to those who underwent surgery alone (22.5% and 40.7%, respectively), with p-values of 0.035 and 0.003, respectively. However, by the 10-year follow-up, recurrence rates were not significantly different between the groups (50% in the radiation therapy group vs. 59.1% in the surgery-only group; p= 0.9). OS demonstrated no statistical difference between treatments (129.52 months ± 16.2 vs 149.31 months ± 19.1; p= 0.34).
Conclusion : In grade 2 or 3 meningiomas, SRS may be beneficial in reducing recurrence for the first 5 years following surgical resection but does not provide benefit past 10 years. It also does not seem to improve overall survival. Preliminary results should be confirmed in larger datasets.
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