Abstract
PurposeDisruption of the tumor-brain barrier in meningioma is a crucial factor in peritumoral brain edema (PTBE). We previously reported the possible effect of osteoporosis on the integrity of the arachnoid trabeculae because both the bone and the arachnoid trabeculae are composed of type 1 collagen. We hypothesized that osteoporotic conditions may be associated with PTBE occurrence after radiation treatment in patients with meningioma.MethodsA receiver operating characteristic curve analysis was used to identify the optimal cut-off values of mean skull Hounsfield unit for predicting osteopenia and osteoporosis in patients from our registry. Multivariate Cox regression analysis was used to determine whether possible osteoporosis independently predicted PTBE development in patients with meningioma after radiation.ResultsA total of 106 intracranial meningiomas were included for the study. All patients received linear accelerator-based radiation therapy in our hospital over an approximate 6-year period. Multivariate Cox regression analysis identified that hypothetical osteoporosis was an independent predictive factor for the development of PTBE in patients with meningioma after linear accelerator-based radiation treatment (hazard ratio 5.20; 95% confidence interval 1.11–24.46; p = 0.037).ConclusionsOur study suggests that possible osteoporotic conditions may affect PTBE development after linear accelerator-based radiation treatment for intracranial meningioma. However, due to the study’s small number of patients, these findings need to be validated in future studies with larger cohorts, before firm recommendations can be made.Graphic abstract
Highlights
Radiation therapy is the primary treatment for patients with small (< 3 cm) asymptomatic tumors or tumors located in the cranial base [1]
To predict bone mineral density (BMD), we previously reported a method for prediction of osteoporosis by measuring frontal skull Hounsfield unit (HU) values on the brain CT [6]
Because osteoporotic conditions may negatively affect the integrity of the brain-meningioma interface, which is composed of arachnoid trabeculae, in this study, we examined whether osteoporotic conditions were associated with peritumoral brain edema (PTBE) occurrence after radiation treatment in patients with meningioma
Summary
Kang et al Radiat Oncol (2021) 16:160 treatment-related PTBE [2] Several risk factors such as greater radiation dose, larger tumor size, tumor location, brain-tumor interface, no prior resection for meningioma, atypical histology, and presence of pretreatment edema were reported to be associated with PTBE after radiosurgery in meningioma [2, 3]. To predict bone mineral density (BMD), we previously reported a method for prediction of osteoporosis by measuring frontal skull Hounsfield unit (HU) values on the brain CT [6]. Both the bone and the arachnoid trabeculae are composed of type 1 collagen. We used skull HU values to report the possible effect of systemic osteoporosis on the integrity of the arachnoid trabeculae [6, 7]
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