2491 - Outcomes Following Proton Radiation for Pediatric Meningiomas
Presenter(s)
E. Thompson1, D. J. Indelicato2, R. J. Brisson1, J. A. Bradley1, D. Klawinski3, N. J. Ranalli4, C. G. Morris1, and R. Mailhot Vega1; 1Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL, 2Department of Radiation Oncology, University of Florida, Jacksonville, FL, 3Department of Pediatric Hematology/Oncology, Nemours Children’s Specialty Care, Jacksonville, FL, 4Department of Neurosurgery, University of Florida College of Medicine Jacksonville, Jacksonville, FL
Purpose/Objective(s): Pediatric meningiomas make up 2% of all pediatric CNS tumors and are distinct from adult meningiomas, often coinciding with neurofibromatosis-2 (NF2). However, there is limited useful outcome data regarding pediatric meningiomas treated with radiation therapy.
Materials/Methods: We reviewed 18 patients with meningioma under the age of 21 treated at our institution between 2006 and 2024. All patients were treated to a total dose of 50.4-59.4 Gy in 1.8 Gy/fraction daily, based on tumor grade. The study included nine patients with WHO grade 1 meningioma or a radiographic diagnosis and 9 patients with WHO grade 2 meningiomas. Sixteen of 18 patients had gross disease at the time of radiation. There was a 1:1 male to female ratio. Seven of 18 patients had a diagnosis of NF2. Descriptive statistics were used to describe demographics. Kaplan-Meier statistical analysis was employed to estimate progression-free survival, local recurrence, and overall survival rates.
Results: The median follow-up was 8.5 years. No patients were lost to follow-up. At 10 years, the local control was 87%, progression free survival was 75%, and overall survival was 94%. One patient died from a radiation-associated second neoplasm and one died from cerebral vasculopathy occurring in the high dose region. Notable other radiation-related toxicity included hearing loss, cataract formation, hormone abnormalities, and alopecia. No patients had new onset blindness or vision loss.
Conclusion: This study contributes valuable outcome data for children with meningioma requiring radiotherapy. Long-term disease control was encouraging and aligned with adult meningioma data. Despite the use of proton therapy, we observed infrequent but serious radiation toxicity.