Proton therapy for atypical meningiomas

Mark W. McDonald, David A. Plankenhorn, Kevin P. McMullen, Mark A. Henderson, Edward J. Dropcho, Mitesh V. Shah, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


We report clinical outcomes of proton therapy in patients with World Health Organization grade 2 (atypical) meningiomas. Between 2005 and 2013, 22 patients with atypical meningiomas were treated to a median dose of 63 Gy (RBE) using proton therapy, as an adjuvant therapy after surgery (n = 12) or for recurrence or progression of residual tumor (n = 10). Six patients had presumed radiation-induced meningiomas, but none had received prior radiotherapy for their meningioma. The median follow-up time after radiation was 39 months (range 7–104) and all patients remain alive at last follow-up. The 5-year estimate of local control was 71.1 % (95 % CI 49.3–92.9 %). The 5-year estimate of local control was 87.5 % following a radiation dose >60 Gy (RBE), compared to 50.0 % for ≤60 Gy (RBE) (p = 0.038). The 5-year estimate of neuraxis dissemination was 5 % (95 % CI 0–14.6 %) and 6.2 % (95 % CI 0–18.2 %) for metastases outside of the central nervous system. Radiation necrosis was observed in one patient with a history of prior cranial irradiation. Fractionated proton therapy was associated with favorable tumor control rates for grade 2 meningiomas. Prospective studies are needed to define the optimal radiation dose for high-grade meningiomas.

Original languageEnglish (US)
Pages (from-to)123-128
Number of pages6
JournalJournal of Neuro-Oncology
Issue number1
StatePublished - May 26 2015


  • Atypical
  • Meningioma
  • Proton therapy
  • Radiation

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology

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