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Prolonged Oral Hydroxyurea and Concurrent 3d-Conformal Radiation in Patients with Progressive or Recurrent Meningioma: Results of a Pilot Study

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Summary

Purpose: Treatment of recurrent and progressive meningiomas remains a challenge in clinical neurooncology. This study was designed to evaluate the efficacy of the simultaneous application of 3d-conformal radiotherapy and chemotherapy with hydroxyurea (HU).

Patients and methods: Twenty-one patients with recurrent or progressive meningiomas (13 benign, 4 atypical and malignant, 4 with unproven histology) received treatment by fractionated 3d-conformal radiation (55.8–59.4 Gy) and concurrent HU, administered for a median time of three months with a daily dosage of 20 mg/kg. Response was evaluated using clinical and neuro-imaging data.

Results: Disease stabilization was achieved in 14/21 patients (pts). Three pts had significant improvement of tumor associated neurological symptoms with imaging criteria of minor response. Progression free survival rates 1 year and 2 years after the initiation of radio-chemotherapy were 84% and 77%, respectively. At the time of analysis a total of 6/21 pts presented with progressive disease with a median time to progression of 59 weeks. Documented radio- and chemotherapy associated toxicity was minimal; only one patient discontinued HU treatment due to gastrointestinal symptoms such as anorexia and weight loss.

Conclusion: Results obtained in this study indicate that treatment with HU and simultaneous radiotherapy is safe and effective with disease stabilization in the majority of patients. Randomized trials comparing radiosurgery versus radiochemotherapy versus fractionated radiotherapy are warranted.

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Authors and Affiliations

  1. Department of Radiation Oncology and NOVALIS Shaped Beam Surgery Center, University of Erlangen, 91054, Erlangen, Germany

    Barbara M. Hahn, Rolf Sauer & Gerhard G. Grabenbauer

  2. Neurosurgery, NOVALIS Shaped Beam Surgery Center of the University Hospitals of Erlangen, Germany

    Ulrich M. H. Schrell, Rudolf Fahlbusch & Oliver Ganslandt

  3. NOVALIS Shaped Beam Surgery Center of the University Hospitals of Erlangen, Erlangen, Germany

    Oliver Ganslandt & Gerhard G. Grabenbauer

Authors
  1. Barbara M. Hahn
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  2. Ulrich M. H. Schrell
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  3. Rolf Sauer
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  4. Rudolf Fahlbusch
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  5. Oliver Ganslandt
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  6. Gerhard G. Grabenbauer
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Correspondence to Gerhard G. Grabenbauer.

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Hahn, B.M., Schrell, U.M.H., Sauer, R. et al. Prolonged Oral Hydroxyurea and Concurrent 3d-Conformal Radiation in Patients with Progressive or Recurrent Meningioma: Results of a Pilot Study. J Neurooncol 74, 157–165 (2005). https://doi.org/10.1007/s11060-004-2337-3

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