Prognostic factors affecting overall survival and local control in meningioma patients treated with radiotherapy or combined radiotherapy and surgery

Meningiomas account for 15-20% of adult primary brain neoplasms. We reviewed 142 meningioma cases treated with radiotherapy (RT) alone or combined RT and surgery to assess prognostic factors affecting overall survival (OS) and local control (LC). Medical records were reviewed for progesterone receptor (PR) status, World Health Organization (WHO) grade, and treatment given, and we evaluated how these factors affected OS and LC. We also assessed OS and LC in patients treated with adjuvant RT versus salvage RT. From 1997 to 2014, 142 patients with meningioma were treated with RT. The median follow-up time since the completion of RT was 4.43 years. When adjusted for age at diagnosis, there was no difference in OS for surgery + RT versus RT alone, p = 0.656. Local control at 5 years was 88.2% with adjuvant RT versus 74.9% with salvage RT, p = 0.326. Five-year OS and LC were higher for grade I (OS 92.4%, LC 80.8%) versus grade II or higher meningiomas (OS 88.0%, LC 53.7%), p < 0.05. Five-year LC was 82.9% in women and 64.2% in men, p = 0.011. Local control at 5 years was 76.1% in patients with strong PR expression versus 41.7% in patients with focal or no PR expression, p = 0.029. We confirm that meningioma grade is prognostic for OS and LC. Gender and PR status were prognostic with respect to LC, with significantly better LC in women and patients with strong PR expression.