S369
Clinical - CNS
ESTRO 2026
fractions (35 Gy, with a simultaneous integrated boost [SIB] of 42 or 46 Gy to MRI-identified gross residual disease, or a total dose of 35, 42, or 46 Gy) or 15 fractions (total dose of 52.5 Gy). One patient received the 15-fraction regimen due to a high-volume planning target volume (PTV), and seven patients received SIB to the gross residual tumor. Toxicity was assessed and reported according to the Common Terminology Criteria for Adverse Events (CTCAE). Results: The mean follow-up duration was 8 months (range:3– 32 months). Magnetic resonance imaging (MRI) follow- up revealed no cases of radionecrosis, disease progression, or relapse in the entire patient cohort. At the time of analysis, five patients achieved complete remission, including three with gross residual disease identified on postoperative MRI, and three patients showed partial remission. No patients experienced toxicity higher than grade 2 according to CTCAE criteria; headache was a frequently reported side effect. Conclusion: Our institutional experience indicates that hypofractionated schedules for PORT in patients with WHO Grade II meningiomas are effective, as evidenced by an increased biologically effective radiation dose (higher EQD2) within the PTV. This approach results in improved local control with a favorable safety profile and low incidence of significant toxicity. References: Effectiveness of postpoperative adjuvant radiotherapy in atypical meningioma patients after total gross resection: a meta-analysisL He, B Zhang, J Zhang, Z Guo, F Shi and Q ZengFrontiers in Oncology January 2021 volume 10Risk of tumor recurrence in intracranial meningiomas: comparative analyses of the predictive value ofthe postoperative tumor volume and the Simpson classification Spille DC, Hess K, Bormann E, Sauerland C, Brokinkel C, Warneke N, Mawrin C, Paulus W, Stummer W, Brokinkel B.J Neurosurg 134:1764–1771, 2021Long-term outcome of moderate hypofractionated stereotactic radiotherapy for meningiomasE Maranzao, L Draghini, M Casale, F Arcidiacono, P Anselmo, F Trippa, C Giorgi.Strahlenther Onkol (2015) 191:953–960 Keywords: meningiomas, hypofractionated radiotherapy
had decreasing Vrel but dmigrate >5mm. Conclusion:
Significant changes in tumour dynamics were detected during the course of chemoradiation for GBM. Volume increases were most prominent in patients with unmethylated tumors and those who underwent STR or biopsy only. Early progressors also exhibited marked volumetric expansion during treatment, suggesting a potential role for on-treatment imaging in identifying high-risk patients. Keywords: glioblastoma, MR-Linac, tumour dynamics Postoperative adjuvant radiotherapy for intracranial WHO Grade II meningiomas: monoinstitutional experience with VMAT hypofractionated schedules Patrizia Massaro 1,2 , Marianna Luongo 3 , Giulio Cecchini 3 , Francesco Di Biase 3 , Angelo Dinota 4 , Tina Salerno 4 , Domenico Bilancia 4,5 , Giuseppe V. Giovinazzo 1,2 1 Radiation Oncology Unit, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy. 2 Amethyst ROI, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy. 3 Neurosurgery Unit, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy. 4 Medical Oncology Digital Poster 2021 Unit, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy. 5 Oncoematological Department, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy Purpose/Objective: Postoperative adjuvant radiotherapy (PORT) has demonstrated benefits for patients with intracranial WHO Grade II meningiomas, despite reports of relatively high local progression rates. The evaluation of highly conformal radiotherapy techniques is essential, particularly regarding their efficacy and safety, to support the implementation of dose- escalation strategies intended to enhance local control rates. Here, we present the findings from our recent single-institution experience involving PORT for intracranial WHO Grade II meningiomas, specifically utilizing volumetric modulated arc therapy (VMAT) with hypofractionated treatment schedules. Material/Methods: We performed a retrospective analysis of patients who received VMAT-based hypofractionated PORT at our institution from June 2022 through June 2025. This study included newly diagnosed patients with WHO Grade II meningiomas who had undergone Simpson grade 1 to 4 surgical resection. Clinical records of 13 patients were reviewed, with a mean age of 65 years (ranging from 38 to 78 years). Of these, eight were female. The VMAT dose regimens included either 10
Digital Poster 2076
Benchmarking the impact of maximal treatment on real-world survival of glioblastoma patients for future trials of novel local treatments. Stephen D Robinson 1,2 , Faye Robertson 3,4 , Sarah Kingdon 3,5 , Paul Brennan 6,7 , Giles Critchley 8,9
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