{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:54:34Z","timestamp":1787507674736,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001661","name":"Universit\u00e4t Heidelberg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiotherapy plays an important role in the management of skull base meningioma. The aim of the study was to investigate patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A questionnaire of 20 items was sent to 192 patients with meningioma of the skull base who have been treated with proton therapy at a single institution. The survey included dichotomous, scaling, and open questions about symptoms, social distancing, rehabilitation, work, reintegration, limitations in recreational activities, as well as daily life activities and correlating diagnoses. Additionally, symptoms were reported retrospectively by the patients at different time points. In total, 128 patients (66.7%) responded. The median age at the time of RT was 55 years (range: 28-91); the majority were female (79%). The median time between the treatment of meningioma and the survey was 38.5 months (range: 7-100).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The most common initial symptoms were visual impairment (\n                      <jats:italic>N<\/jats:italic>\n                      =54, 42.2%), dizziness (\n                      <jats:italic>N<\/jats:italic>\n                      =38, 29.7%), and double vision (\n                      <jats:italic>N<\/jats:italic>\n                      =32, 25%). The most limiting symptom in daily life at the time of the survey was fatigue (\n                      <jats:italic>N<\/jats:italic>\n                      =31, 24.2%); a significant proportion of patients reported depression as associated with diagnosis (31.3%). Only 53% of patients reported occupational activity before treatment, this number did not increase with time. Only\n                      <jats:italic>N<\/jats:italic>\n                      = 40 (31.3%) and\n                      <jats:italic>N<\/jats:italic>\n                      =35 (27.3%) patients reported no limitations in daily household chores or recreational activities by the disease and treatment. The course of cognitive function after treatment showed a temporary deterioration with subsequent improvement. Except for the improvement in emotional functioning, most domains showed a temporary deterioration during radiotherapy, still, the values reached after 6 months differed weekly or moderately from the initial values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Besides neurological deficits, patients with skull base meningioma experience a variety of unspecific symptoms, which can be most limiting in daily life. Even successful treatment does not necessarily translate into the alleviation of those symptoms. A greater focus on the characterization of those symptom complexes is necessary. Greater focus on functional structures such as the hippocampus might improve the results. Due to the retrospective character, this study is hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2022.677181","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T17:38:58Z","timestamp":1659721138000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The Patient\u2019s Perspective on Proton Radiotherapy of Skull Base Meningioma: A Retrospective Cross-Sectional Survey"],"prefix":"10.3389","volume":"12","author":[{"given":"Katharina","family":"Seidensaal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Sailer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semi Ben","family":"Harrabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"von Gehlen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Seidensaal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Weykamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Bernhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Debus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Herfarth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30321-7","article-title":"EANO guidelines for the diagnosis and treatment of meningiomas","volume":"17","author":"Goldbrunner","year":"2016","journal-title":"Lancet Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1186\/1748-717X-7-226","article-title":"State-of-the-art treatment alternatives for base of skull meningiomas: complementing and controversial indications for neurosurgery, stereotactic and robotic based radiosurgery or modern fractionated radiation techniques","volume":"7","author":"Combs","year":"2012","journal-title":"Radiat Oncol (London England)."},{"key":"B3","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s13014-018-1002-5","article-title":"Clinical outcome after particle therapy for meningiomas of the skull base: toxicity and local control in patients treated with active rasterscanning","volume":"13","author":"El Shafie","year":"2018","journal-title":"Radiat Oncol (London England)."},{"key":"B4","article-title":"Evidence level in the treatment of meningioma with focus on the comparison between surgery versus radiotherapy","volume":"55","author":"Pechlivanis","year":"2011","journal-title":"A review. J neurosurgical Sci"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.06.127","article-title":"Trends in Management of Intracranial Meningiomas: Analysis of 49,921 Cases from Modern Cohort","volume":"106","author":"Agarwal","year":"2017","journal-title":"World neurosurgery."},{"key":"B6","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1055\/s-2004-821364","article-title":"Management of benign skull base meningiomas: a review","volume":"14","author":"Mendenhall","year":"2004","journal-title":"Skull Base."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.2590","article-title":"Differences in the Acute Toxic Effects of Breast Radiotherapy by Fractionation Schedule: Comparative Analysis of Physician-Assessed and Patient-Reported Outcomes in a Large Multicenter Cohort","volume":"1","author":"Jagsi","year":"2015","journal-title":"JAMA Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.5.365","article-title":"The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology","volume":"85","author":"Aaronson","year":"1993","journal-title":"J Natl Cancer Institute."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-014-2352-7","article-title":"Comparison of the EORTC QLQ-BN20 and the FACT-Br quality of life questionnaires for patients with primary brain cancers: a literature review","volume":"22","author":"Chow","year":"2014","journal-title":"Supportive Care Cancer Off J Multinational Assoc Supportive Care Cancer."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/BF00435979","article-title":"The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires","volume":"5","author":"Osoba","year":"1996","journal-title":"Qual Life Res an Int J Qual Life aspects treatment Care rehabilitation."},{"key":"B11","article-title":"Petroclival and Upper Clival Meningiomas I","volume-title":"An Overview of Surgical Approaches","author":"Ware","year":"2009"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02767","article-title":"Hippocampal Avoidance During Whole-Brain Radiotherapy Plus Memantine for Patients With Brain Metastases: Phase III Trial NRG Oncology CC001","volume":"38","author":"Brown","year":"2020","journal-title":"J Clin Oncol Off J Am Soc Clin Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70290-4","article-title":"Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial","volume":"12","author":"Nutting","year":"2011","journal-title":"Lancet Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noy152","article-title":"Life after surgical resection of a meningioma: a prospective cross-sectional study evaluating health-related quality of life","volume":"21","author":"Nassiri","year":"2019","journal-title":"Neuro-Oncology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1093\/nop\/npz023","article-title":"Prevalence and correlates of fatigue in patients with meningioma before and after surgery","volume":"7","author":"van der Linden","year":"2020","journal-title":"Neurooncol Pract"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30975","article-title":"Quality of life after surgery for intracranial meningioma","volume":"124","author":"Benz","year":"2018","journal-title":"Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S150464","article-title":"The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis","volume":"14","author":"Kessels","year":"2018","journal-title":"Neuropsychiatr Dis Treat"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-011-1227-4","article-title":"Examining the role of physical activity in reducing postcancer fatigue","volume":"20","author":"Gielissen","year":"2012","journal-title":"Supportive Care Cancer."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603899","article-title":"Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up","volume":"97","author":"Gielissen","year":"2007","journal-title":"Br J Cancer."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.8270","article-title":"Effects of cognitive behavior therapy in severely fatigued disease-free cancer patients compared with patients waiting for cognitive behavior therapy: a randomized controlled trial","volume":"24","author":"Gielissen","year":"2006","journal-title":"J Clin Oncol Off J Am Soc Clin Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-013-1688-3","article-title":"Pr\u00e4valenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland","volume":"56","author":"Busch","year":"2013","journal-title":"Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npz066","article-title":"Return to work following meningioma surgery: a Swedish nationwide registry-based matched cohort study","volume":"7","author":"Jakola","year":"2020","journal-title":"Neuro-Oncology Practice."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1023\/A:1006476604338","article-title":"Quality of life following surgery for intracranial meningiomas at Brigham and Women's Hospital: a study of 164 patients using a modification of the functional assessment of cancer therapy-brain questionnaire","volume":"48","author":"Kalkanis","year":"2000","journal-title":"J neuro-oncology."},{"key":"B24","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.ctro.2020.09.003","article-title":"Late toxicity in the brain after radiotherapy for sinonasal cancer: Neurocognitive functioning, MRI of the brain and quality of life","volume":"25","author":"Sharma","year":"2020","journal-title":"Clin Trans Radiat Oncol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1093\/cercor\/bht260","article-title":"Large-Scale Brain Networks of the Human Left Temporal Pole: A Functional Connectivity MRI Study","volume":"25","author":"Pascual","year":"2015","journal-title":"Cereb Cortex."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opy260","article-title":"A Connectomic Atlas of the Human Cerebrum-Chapter 6: The Temporal Lobe","volume":"15","author":"Baker","year":"2018","journal-title":"Operative Neurosurg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.57.2909","article-title":"Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933): a phase II multi-institutional trial","volume":"32","author":"Gondi","year":"2014","journal-title":"J Clin Oncol Off J Am Soc Clin Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.03.024","article-title":"Dose-dependent atrophy of the amygdala after radiotherapy","volume":"136","author":"Huynh-Le","year":"2019","journal-title":"Radiotherapy Oncol J Eur Soc Ther Radiol Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2004.10.027","article-title":"Amygdala and hippocampus volumes in pediatric major depression","volume":"57","author":"Rosso","year":"2005","journal-title":"Biol Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2008.10.027","article-title":"Amygdala Volume Marks the Acute State in the Early Course of Depression","volume":"65","author":"van Eijndhoven","year":"2009","journal-title":"Biol Psychiatry"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.10.056","article-title":"Projected second tumor risk and dose to neurocognitive structures after proton versus photon radiotherapy for benign meningioma","volume":"83","author":"Arvold","year":"2012","journal-title":"Int J Radiat oncology biology physics."}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.677181\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T17:39:02Z","timestamp":1659721142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.677181\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,5]]},"references-count":31,"alternative-id":["10.3389\/fonc.2022.677181"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2022.677181","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,5]]},"article-number":"677181"}}