Earlier and sustained response with incidental use of cardiovascular drugs among patients with low- to medium-grade meningiomas treated with radiosurgery (SRS) or stereotactic radiotherapy (SRT)

Radiother Oncol. 2014 Jun;111(3):446-50. doi: 10.1016/j.radonc.2014.05.014. Epub 2014 Jul 3.

Abstract

Background and purpose: Beneficial outcome for cancer treated with radiotherapy (RT) and β-blockers has been reported. We hypothesize a potential combined impact of stereotactic RT with incidental use of cardiovascular drugs also in meningiomas.

Materials and methods: In 64 patients with 70 intracranial meningiomas (male/female=17/53; median follow-up=2 years) from a prospective database with sustained RT/cardiovascular drug therapy tumor response (progression, stable disease, regression) was evaluated at predefined follow-up intervals of 3, 12 and 24 months based on MR-imaging. For this retrospective cohort analysis stepwise univariate and multivariate analyses for group comparison were performed. Between groups analysis and stepwise uni- and multivariate analysis was performed.

Results: At one year follow-up there was a significant better tumor response for patients with antihypertensives use (p=0.008) and radiosurgery (SRS) (p=0.054), the difference between patients with and without antihypertensive medication remains significant in multivariate analysis. Two years after RT, only patients with β-blocker use had a significant better response to RT (p=0.032). Additionally, for the use of β-blockers a trend toward significance for early tumor response at 3 months compared to the control group was observed (p(one tailed)=0.059).

Conclusions: Our data suggest that concomitant antihypertensive medication (especially β-blockers) may lead to an earlier and sustained response in stereotactic irradiated low- to medium-grade intracranial meningiomas by affecting the β-adrenergic pathways.

Keywords: Beta-blocker; Meningioma; Radiation therapy; Radiosurgery.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Cardiovascular Agents / therapeutic use*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meningeal Neoplasms / drug therapy*
  • Meningeal Neoplasms / pathology
  • Meningeal Neoplasms / surgery*
  • Meningioma / drug therapy*
  • Meningioma / pathology
  • Meningioma / surgery*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Prospective Studies
  • Radiosurgery / methods*
  • Retrospective Studies
  • Sympathomimetics / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Cardiovascular Agents
  • Sympathomimetics