Radiotherapy of recurrence of intracranial meningiomas supratentorial localization
Keywords:
intracranial meningiomas, relapse, radiosensitivityAbstract
The carried out retrospective analysis of results of treatment 43 patients with relapses of meningiomas for the period 1990—2000. For these years, alongside with a surgical intervention, the systematic introduction himioradiach of treatment atipical, anaplastic and sarcomatothis meningiomas was marked. Average term of occurrence of relapses has made 17 months. Most magna a part of relapses revealed in the first 24 months after treatment of a primary tumour.
The rates of development of relapses after surgical treatment, as a whole, were higher, than after association of operation with radial or medicamental (hormonal) therapy. The most favorable results of radical treatment of relapses were received at skulbeas localization of a tumour: more than 60 % of the patients was life the greater 5 years. It is a little bit less than a level of a general survival, but in 1,5 times there is less reliability, the complete convalescence is achieved at the patients with relapsing parasagittal by meningiomas.
In group of the patients with total remove recurrence of meningiomas without the carried out radial therapy, in 2 years, the relapses are revealed in 30—75 % cases, and after the carried out radial therapy — only in 25 %.
Generalizing the received results, is revealed, that the choice of adequate volume of irradiated tissues has the much greater importance for rising frequency of local treatment of relapses of meningiomas, than change of size of a focal dose in a range 40—70 Gr. The critical factor of the forecast is size of a recurrent tumor: the downstroke of a radiosensitiveness on a background of sharp rising of reliability of a progression was observed at relapsing tumours, which had the maximal size greater 3 sm. in a diameter.
The correctly planned and carried out postoperative irradiation of a zone of initial body height of a tumour and zone invasion of tissues reduces reliability of occurrence of relapses.References
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