Hydroxyurea Treatment of Meningiomas: A Pilot Study

Abstract

OBJECTIVES: To present a pilot study of hydroxyurea chemotherapy in the management of surgically difficult meningiomas. DESIGN: Prospective case series. SETTING: Tertiary referral center. PARTICIPANTS: Six patients were enrolled: five had symptomatic recurrent or residual WHO Grade I meningiomas and one had an unoperated anterior clinoidal meningioma. MAIN OUTCOME MEASURES: MRI volumetry before and after treatment, hematological state, progression to surgery. RESULTS: Hydroxyurea was administered for 1 year, starting at a dose of 15 mg/kg/day. No tumors reduced in size on treatment and one continued to grow rapidly. Three remained stable. Full volumetry was unavailable on two patients. One patient was withdrawn from the study because of myelosuppression and underwent further surgery. Three experienced significant drug-related side effects. Two patients underwent further surgery. CONCLUSIONS: From this small pilot study we conclude that although hydroxyurea may be associated with disease stabilization in some patients, it did not reduce tumor mass and it caused significant side effects in some of our subjects.