Adjuvant combined modality therapy for malignant meningiomas
Adjuvant combined modality therapy for malignant meningiomas
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DOI：
10.3171/jns.1996.84.5.0733
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发表时间：
1996-05-01
影响因子：
4.1
通讯作者：
Chamberlain, MC
中科院分区：
文献类型：
--
作者：
Chamberlain, MC
恶性脑膜瘤占所有脑膜瘤的10%至15%，关于这些侵袭性原发性脑肿瘤的辅助治疗信息有限。根据机构方案，前瞻性治疗年龄在28 - 61岁（中位数51岁）的青少年恶性脑膜瘤患者（8名男性，6名女性）。所有患者均接受手术治疗（4例全切除，10例次全切除），然后在2至4周内接受受累野放疗（范围59-60戈伊，中位剂量60戈伊）。放疗后2 ~ 4周，所有患者均接受辅助化疗，包括环磷酰胺、阿霉素和长春新碱（CAV）。接受大体全切除术的患者接受了3个周期，而次全切除术的患者接受了6个周期的CAV。4例患者因骨髓抑制而需要减少CAV剂量，3例患者因骨髓抑制而无法按计划进行CAV治疗。4名患者需要输血（4名接受红细胞，3名接受血小板），2名患者出现血小板减少性发热，无细菌学记录。神经放射学反应包括3例部分反应和11例疾病稳定。肿瘤进展的中位时间为4.6年（范围2.2-7.1年），中位生存期为5.3年（范围2.6-7.6年）。作者得出结论，与单纯手术治疗的患者相比，联合治疗恶性脑膜瘤的毒性可接受，生存率略有改善。
Malignant meningiomas constitute 10% to 15% of all meningiomas and limited information exists regarding adjuvant treatment of these aggressive primary brain tumors. Foul teen patients (eight men, six women), ranging in age from 28 to 61 years (median 51 years), were prospectively treated for primary malignant meningiomas according to an institutional protocol. All patients underwent surgery (gross-total in four and subtotal resection in 10 patients) followed in 2 to 4 weeks by involved-field radiotherapy (range 59-60 Gy, median dose 60 Gy). Two to 4 weeks after radiotherapy all patients were treated with adjuvant chemotherapy that included cyclophosphamide, adriamycin, and vincristine (CAV). Patients who underwent gross-total resection received three cycles, whereas those with subtotal resection received six cycles of CAV.Four patients required CAV dose reduction due to myelosuppression, and in three patients, myelosuppression prevented administration of the planned course of CAV. Four patients required transfusions (four received red blood cells, three received platelets), and two developed neutropenic fever without bacteriological documentation. Neuroradiographic response included three partial responses and 11 with stable disease. The median time to tumor progression was 4.6 years (range 2.2-7.1 years) and median survival was 5.3 years (range 2.6-7.6 years). The author concludes that combined modality therapy for the treatment of malignant meningiomas is associated with acceptable toxicity and a modest improvement in survival when compared to patients treated with surgery alone.