Journal of Neuro-Oncology最新文献

{"title":"Evaluating the role of gross total resection in primary spinal cord glioblastoma: evidence from a multicenter cohort and meta-analysis.","authors":"Giuseppe Corazzelli, Sergio Corvino, Luigi Sigona, Valentina Cioffi, Francesco Ricciardi, Maria Rosaria Scala, Cristina Mancarella, Ciro Mastantuoni, Anthony Kevin Scafa, Francesco de Falco, Valentina Pizzuti, Alessandro D'Elia, Settimio Leonetti, Salvatore Di Colandrea, Giuseppe Catapano, Antonio Bocchetti, Sergio Paolini, Vincenzo Esposito, Gualtiero Innocenzi, Raffaele de Falco","doi":"10.1007/s11060-025-05158-y","DOIUrl":"10.1007/s11060-025-05158-y","url":null,"abstract":"<p><strong>Background: </strong>Primary spinal cord glioblastoma (PscGB) is a rare, aggressive tumor that accounts for about 7.5% of spinal cord gliomas. Its infiltrative growth and proximity to critical neural structures make diagnosis and management challenging, and data on prognostic factors and optimal treatment remain limited.</p><p><strong>Objective: </strong>To evaluate the impact of the extent of surgical resection and adjuvant chemoradiotherapy on overall survival (OS) in PscGB, and to identify independent predictors of poor prognosis.</p><p><strong>Methods: </strong>A retrospective multicenter cohort was analyzed alongside a systematic review and meta-analysis of comparative clinical studies. Through stringent enrollment criteria, demographic, clinical, radiological, and surgical data were collected. The overall survival (OS) was the primary outcome. Survival outcomes were evaluated with Kaplan-Meier curves, while predictors of better OS were identified using univariate and multivariate least squares regression. For the meta-analysis, individual patient data were retrieved where available, and a random-effects model using hazard ratios (HR) assessed the effects of extent of resection and adjuvant therapy on survival.</p><p><strong>Results: </strong>The multicenter cohort (n = 13) and systematic review (n = 67) together included 80 operated PscGB patients. The meta-analysis combined data from five published comparative studies plus our institutional series, for a total of 111 patients. No significant difference in OS was observed among patients undergoing gross total resection, subtotal resection, or biopsy (HR = 0.68, 95% CI: 0.29-1.58; p = 0.37). In contrast, adjuvant chemoradiotherapy was significantly associated with improved survival (HR = 0.37, 95% CI: 0.17-0.78; p = 0.009). Multivariate analysis identified delayed surgery (p < 0.01) and absence of adjuvant chemoradiotherapy (p < 0.01) as independent predictors of poorer OS. Sensitivity and publication bias analyses supported the robustness of these findings.</p><p><strong>Conclusion: </strong>In this study, gross total resection did not provide a significant survival benefit in PscGB, while earlier surgery and adjuvant chemoradiotherapy were associated with improved outcomes. However, our findings are to be interpreted as merely observational and not conclusive and therefore should be observed with caution. Larger prospective studies are needed to confirm these results and inform clinical practice.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"633-645"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the RANO-resect criteria in elderly patients with glioblastoma.","authors":"Josh Bandopadhay, Pavel S Pichardo-Rojas, Rhea Cho, Elham Tavakkol, Kamand Khalaj, Andres Rodriguez, Antonio Dono, Roy Riascos, Nitin Tandon, Yoshua Esquenazi","doi":"10.1007/s11060-025-05168-w","DOIUrl":"10.1007/s11060-025-05168-w","url":null,"abstract":"<p><strong>Introduction: </strong>Elderly patients with IDH-wild type glioblastoma (IDH-WT GBM) have a dismal prognosis compared to younger patients. Given the prognostic relevance of extent of resection (EOR), we aimed to assess the prognostic utility of the Response Assessment in Neuro-Oncology (RANO)-resect classification in this population.</p><p><strong>Methods: </strong>We retrospectively analyzed patients ≥ 65 years who underwent resection for newly diagnosed IDH-WT GBM between 2005 and 2023. EOR was categorized per RANO-resect classifications based on volumetric MRI analysis.</p><p><strong>Results: </strong>Among 147 patients, 54 (36.7%) had Class 1 and 2 resection, 70 (47.6%) had Class 3 resection, and 23 (15.6%) underwent biopsy. The incidence of postoperative neurological and non-neurological complications was comparable across RANO-resect classes. Median overall survival (OS) was significantly longer for Class 1 and 2 resection (16.0 months, 95% CI: 10.4-21.7) versus Class 3 (10.6 months, 95% CI: 9.1-12.1) and biopsy (8.8 months, 95% CI: 4.0-13.5) (p = 0.033). Progression-free survival (PFS) did not differ between groups. Notably, in the adjuvant chemoradiotherapy sensitivity analysis, categorical RANO-resect classes showed no OS differences, but residual CE tumor volume remained independently prognostic of OS (HR = 1.006; 95% CI: 1.001-1.010; p = 0.010).</p><p><strong>Conclusion: </strong>While greater EOR within RANO-resect classes correlated with improved OS and similar safety, adjuvant chemoradiotherapy sensitivity analyses showed no categorical OS differences. However, residual CE tumor volume remained independently prognostic of survival. Further studies are needed to clarify the role of surgery in elderly IDH-WT GBM patients.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"721-729"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the Editor: \"Ethnicity in neuro-oncology research: how are we doing and how can we do better?\"","authors":"Asfand Baig Mirza, Feras Fayez, Keyoumars Ashkan","doi":"10.1007/s11060-025-05180-0","DOIUrl":"10.1007/s11060-025-05180-0","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"901-903"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of long-term methylphenidate in preserving intellectual development in survivors of childhood brain tumour.","authors":"Alexander J Hagan, Rebecca M Hill, Andrew Kingston, Simon Bailey, Sarah J Verity","doi":"10.1007/s11060-025-05177-9","DOIUrl":"10.1007/s11060-025-05177-9","url":null,"abstract":"<p><strong>Background: </strong>Survivors of childhood brain tumour face significant neurocognitive late effects, including impairment in processing speed and attention. Deficits to these core cognitive domains contribute to the plateauing of age-appropriate intellectual development as the child matures. While short-term studies demonstrate the utility of methylphenidate in enhancing processing speed and attention during early recovery, its longer-term role in sustaining intellectual development remains underexplored.</p><p><strong>Methods: </strong>The current study examined the long-term effects of methylphenidate on intellectual development in 23 survivors of childhood brain tumour, matched on multiple clinical and demographic variables against 23 controls. Intellectual assessments were conducted at baseline and after 12 months of treatment. Statistical analyses evaluated the degree of change in intellectual trajectories between groups over time.</p><p><strong>Results: </strong>Bayesian hierarchical modelling showed distinct intellectual trajectories between groups, with consistent declines in the control group. Treatment with methylphenidate was associated with the preservation of age-appropriate intellectual development, with the highest posterior probability of treatment-related benefit to Fluid Reasoning (0.97), and strong-to-moderate evidence of benefits to Verbal Comprehension (0.92), Working Memory (0.91), and Processing Speed (0.84). Frequentist analyses supported these findings, demonstrating significant preservation of Fluid Reasoning over time (t = 2.14, p = 0.04). The use of chemotherapy was associated with a significant decline in Fluid Reasoning across the entire dataset; this effect was only sustained in the control group (β = - 18.6, p = 0.03).</p><p><strong>Conclusion: </strong>These findings highlight the long-term rehabilitative potential of methylphenidate and suggest its wider adoption could support care for survivors at risk of intellectual plateau.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"801-812"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regression of sporadic CNS hemangioblastomas with belzutifan.","authors":"Braeden D Newton, Amit R Persad, Julia Radic","doi":"10.1007/s11060-025-05161-3","DOIUrl":"10.1007/s11060-025-05161-3","url":null,"abstract":"","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"897-899"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of maximal and supramaximal resections on postoperative diffusion-weighted imaging changes and clinical outcomes in IDH-wildtype glioblastoma.","authors":"Pavel S Pichardo-Rojas, Josh Bandopadhay, Luis C Nunez, Antonio Dono, Andres Rodriguez, Roy Riascos, Nitin Tandon, Yoshua Esquenazi","doi":"10.1007/s11060-025-05169-9","DOIUrl":"10.1007/s11060-025-05169-9","url":null,"abstract":"<p><strong>Purpose: </strong>The standard of care for glioblastoma (GBM) involves maximal-safe resection. We evaluated the relationship between postoperative diffusion-weighted imaging (DWI) changes, extent of resection (EOR), and clinical outcomes in patients with GBM.</p><p><strong>Methods: </strong>We retrospectively analyzed 323 patients with newly diagnosed IDH-wildtype GBM who underwent surgical resection between 2005 and 2023. EOR was categorized according to RANO-resect categories into supramaximal (class 1), complete (class 2 A), near-total (class 2B), and submaximal (class 3) groups. We assessed postoperative DWI and ADC maps 24-72 h following surgery.</p><p><strong>Results: </strong>Postoperative DWI restriction was detected in 161 patients and was positively correlated with preoperative tumor volume (r = 0.196,p = 0.026). The most common DWI restriction patterns included sector-shaped (59%), rim-shaped (34%), mixed (6%), and remote (1%). DWI restriction incidence was comparable across resection classes: 37.5% in supramaximal resection, 51% in complete resection, 50.9% in near-total resection, and 50.7% in submaximal resection (p = 0.663). Patients who underwent maximal/supramaximal (class 1 and 2) resection had a significantly longer median OS (20 versus 14 months, p = 0.013;multivariate HR = 0.74[95%CI = 0.58-0.96], p = 0.023) and achieved a favorable Karnofsky Performance Score (KPS) ≥ 70 (87.5% vs. 73.0%) over submaximal (class 3) resection (p = 0.001). New neurological deficits were rare in both the maximal/supramaximal (class 1 and 2) (1.7%) and submaximal (class 3) (4.9%) groups (p = 0.278). DWI restriction did not impact survival (p = 0.499).</p><p><strong>Conclusion: </strong>Maximal and supramaximal resections in IDH-wildtype GBM improve survival and function, with low morbidity despite DWI changes. Further research should assess the long-term impact of DWI changes on cognition and quality of life.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"731-739"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is 18F-PSMA PET/CT a reliable imaging modality to evaluate the status of recurrent/residual brain tumors in post-treatment patients?","authors":"Tarun Kumar Jain, Mansha Vohra, Bhawani Shanker Sharma, Anushree Loyal, Priya Sharma, Patel Meet, Shikha Dhal, Vineet Mishra, Jitendra Singh Verma, Surabhi Tyagi, Hemant Malhotra","doi":"10.1007/s11060-025-05167-x","DOIUrl":"10.1007/s11060-025-05167-x","url":null,"abstract":"<p><strong>Background: </strong>Brain tumors are the most challenging malignancies. The existing investigational and treatment modalities have a few drawbacks with high rate of recurrence / residual tumoral tissue. Positron Emitting Tomography combined with computed tomography (PET-CT) is a widely used imaging modality for oncology and non-oncological purposes with fluorine-18-floruodeoxyglucose (18 F-FDG) being the most familiar radiotracer. Physiological uptake of FDG in brain parenchyma makes it a challenging task to currently delineate the residual/ recurrent brain tumors which brings us to investigate new radiotracers.</p><p><strong>Objective: </strong>The purpose of present study is to identify the role of 18 fluoride labelled Prostate Specific Membrane Antigen (PSMA) in residual recurrent brain malignancies and compared the PSMA PET-CT scan with standard conventional imaging in same purpose.</p><p><strong>Methods: </strong>This was a prospective study and patients were enrolled after underwent treatment (surgery and /or concurrent chemoradiotherapy). In order to detection of the residual recurrent disease, 18 F PSMA PET-CT as well as conventional imaging modalities were performed. We calculated the diagnostic performance of the PSMA PET-CT and also compared with standard conventional imaging modalities.</p><p><strong>Results: </strong>Thirty-one patients were included in the study. Out of 31 patients, 23 (~ 74.2%) patients were positive on PSMA PET-CT scan and 18 (~ 58.06%) were on conventional imaging (CI) for residual recurrent mitotic disease. The calculated sensitivity, specificity, PPV, NPV and diagnostic yields for PSMA PET-CT and CI were 96%, 88%, 96%, 88% and 93.5% and 83%, 50%, 83%, 50% and 74.2% respectively. In our study, among 31 patients, 22 patients underwent MRI imaging in form of convention imaging and calculated sensitivity, specificity, PPV, NPV and diagnostic yields for MRI was 81%, 42.85%, 76.5%, 50% and 77.3% respectively. Among these 22 patients, MRI with PSMA PET-CT scan was discordant in 7 patients (27.3%).</p><p><strong>Conclusion: </strong>18 F-PSMA PET-CT imaging has higher diagnostic yield then existing conventional diagnostic modalities with capability to rule out extracranial lesions and inherent-potential of being utilised as theragnostic moiety.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"713-720"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal pemetrexed for newly diagnosed leptomeningeal metastases: a multicenter, open-label, phase I/II study.","authors":"Zhenyu Pan, Xiaojun Ye, Yushan Huang, Panpan Tai, Miaomiao Liu, Xingru Sun, Ran Tang, Anyan Gu, Zhuo Wang, Longhai Shen, Xiaochuan Pang, Tingting Yuan, Guozi Yang","doi":"10.1007/s11060-025-05160-4","DOIUrl":"10.1007/s11060-025-05160-4","url":null,"abstract":"<p><strong>Purpose: </strong>This phase I/II study aimed to determine the maximum-tolerated dose (MTD) of intrathecal pemetrexed (IP) with vitamin supplementation, and to evaluate its safety, feasibility and therapeutic activity for newly diagnosed leptomeningeal metastasis (LM) from solid tumors.</p><p><strong>Methods: </strong>The phase I study followed the classic 3 + 3 design, with IP dose escalating from 15 mg. The recommended dose was applied in the phase II study. IP was administered first as induction therapy twice weekly for 2 weeks, followed by consolidation therapy, once weekly for 4 weeks, then maintenance therapy once monthly. Vitamin supplementation was initiated prior to the first IP dose. The MTD, adverse events (AEs), overall survival (OS), clinical response rate (CRR) and disease control rate (DCR) were evaluated.</p><p><strong>Results: </strong>A total of 34 patients were enrolled. In the phase I study, 2 patients in the 20 mg group experienced dose-limiting toxicity, including grade 4 leukopenia and grade 5 chemical arachnoiditis. The MTD was established as 15 mg. Among 28 patients in the MTD group, 24 completed induction therapy, 19 completed consolidation therapy and 11 proceeded to maintenance therapy. The overall AEs rate was 74% (25/34), and severe AEs rate (> grade 3) was 15% (5/34). In the MTD group, the CRR, DCR and median OS were 46% (13/28), 75% (21/28) and 8.1 months (95% CI, 6.5-11.9).</p><p><strong>Conclusion: </strong>IP at 15 mg, with folic acid and vitamin B12 supplementation initiated before the first IP dose, demonstrated feasibility and exhibited controllable toxicity. This regimen offers a new treatment option with therapeutic activity for newly diagnosed LM patients with solid tumors.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT05289908.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"857-868"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of 18 F-fluciclovine PET for serial assessment of glioblastoma tumor volumes during surgery and radiotherapy.","authors":"Samir A Dagher, Jason M Johnson, Rania M M Mohamed, Shehbaz Ansari, Osama Mawlawi, Ho-Ling Liu, Max Wintermark, Dawid Schellingerhout, Lesley Flynt, Debra N Yeboa, Jeffrey S Weinberg, Sherise D Ferguson, Maria K Gule-Monroe","doi":"10.1007/s11060-025-05146-2","DOIUrl":"10.1007/s11060-025-05146-2","url":null,"abstract":"<p><strong>Purpose: </strong>Recent evidence supports incorporating 18 F-Fluciclovine PET for glioblastoma treatment planning and monitoring, as it better captures tumor infiltration compared to conventional MRI. However, the relationship between PET- and MRI-defined tumor volumes remains unclear, particularly in the post-treatment setting. This study prospectively compares tumor volumes on MRI and PET at multiple timepoints throughout the treatment course and evaluates volumetric changes with therapy.</p><p><strong>Methods: </strong>We prospectively enrolled 8 adults with IDH-wildtype glioblastoma treated with surgery and chemoradiation between September 2019 and 2021. Participants underwent paired 18 F-Fluciclovine PET/CT and conventional MRI at four timepoints: preoperatively, pre-radiation, and at one- and six-months post-radiation. Biological tumor volume (BTV) from PET, FLAIR, and post-contrast T1volumes (T1CV) were segmented. Volumetric changes were compared using the Friedman test.</p><p><strong>Results: </strong>Participants (5 males, median age 63 years [IQR 54,66]) showed significantly larger BTVs compared to T1CV at diagnosis (median BTV = 27.2mL vs. T1CV = 13.3mL, adjusted P =.03), pre-radiation (BTV = 25.2mL vs. T1CV = 6.9mL, adjusted P =.03), and at one-month post-radiation (BTV = 27.3mL vs. T1CV = 12.1mL, P =.04). BTVs closely approximated yet were slightly smaller than their corresponding FLAIR volumes at all timepoints. After surgery, the median decrease in BTV (-4.4%) was significantly smaller than T1CV (-66.5%, P =.046), with a similar nonsignificant trend observed post-radiation (P =.50).</p><p><strong>Conclusion: </strong>Glioblastoma BTVs consistently exceed post-contrast T1 volumes and closely approximate FLAIR abnormalities throughout treatment. BTVs decline more gradually post-treatment, indicating persistent hypermetabolic tumor burden. Thus, 18 F-Fluciclovine PET can serve as an adjunct to conventional MRI in glioblastoma treatment planning and monitoring.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"549-560"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated stereotactic radiosurgery for high grade meningioma.","authors":"Tzu-Chiang Peng, Ming-Hsuan Hsieh, Chun-Fu Lin, Ai Seon Kuan, Cheng-Chia Lee, Hsiu-Mei Wu, I-Chun Lai, Huai-Che Yang","doi":"10.1007/s11060-025-05165-z","DOIUrl":"10.1007/s11060-025-05165-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Atypical and anaplastic meningioma (World Health organization [WHO] Grades II and III) present therapeutic challenges due to their aggressive behavior and high risk of recurrence. This study addressed the lack of data related to the effectiveness and safety of repeated stereotactic radiosurgery (SRS) in managing high-grade recurrent or residual meningioma.</p><p><strong>Methods: </strong>This study analyzed data extracted from the medical records of 112 patients (mean age of 57.9 years) who underwent SRS for recurrent or residual high-grade meningioma between January 2002 and December 2022. The data included clinicodemographic profiles, treatment parameters, and imaging phenotypes. The average follow-up duration was 41.7 months (range 12-160.7 months).</p><p><strong>Results: </strong>There was slight preponderance of females in the cohort (65:47). All patients had undergone craniotomy and histopathologic confirmation of atypical or anaplastic meningioma. Gross tumor resection was achieved in 35 cases. Atypical meningioma accounted for the vast majority of cases (105; 93.8%) with only 7 cases of anaplastic meningioma (6.2%). At a median follow-up of 41.7 months after SRS, tumor control was achieved in 29.5% of cases. Kaplan-Meier analysis indicated overall actuarial progression free survival rates of 79.5%, 43.8% and 30.4% at 1, 3 and 5 years after radiosurgery, respectively. In cases involving repeated SRS, these rates were 97.6%, 69% and 45.2%, respectively. Male sex, older age, anaplastic phenotype, subtotal resection, and larger tumor volume were significantly predictive of tumor growth after treatment. Adverse radiation effects were observed in 33.8% of patients who underwent repeated SRS. Most of those patients were asymptomatic and only five patients required a temporary course of steroid therapy.</p><p><strong>Conclusions: </strong>Our data suggest that SRS is a relatively safe and effective treatment option for recurrent or residual high-grade meningioma, with an acceptable complication profile, even when performed repeatedly. Anaplastic tumor phenotype, subtotal resection, and larger tumor volume were factors associated with tumor growth, warranting close clinical surveillance after radiosurgery.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":"687-695"},"PeriodicalIF":3.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}