Atypical and malignant meningioma: Outcome and prognostic factors in 119 irradiated patients. A multicenter, retrospective study of the Rare Cancer Network
Atypical and malignant meningioma: Outcome and prognostic factors in 119 irradiated patients. A multicenter, retrospective study of the Rare Cancer Network
复制标题
DOI：
10.1016/j.ijrobp.2007.12.020
复制
发表时间：
2008-08-01
影响因子：
7
通讯作者：
Mirimanoff, Rene O.
中科院分区：
文献类型：
--
作者：
Pasquier, David;Bijmolt, Stefan;Mirimanoff, Rene O.
目的：回顾性分析和评估的结果和预后因素，在大量的患者与非典型和恶性meningoma.Methods和材料：10个学术医疗中心参加这一罕见的癌症网络贡献了119例非典型或恶性meningomas治疗外照射放疗（EBRT）手术后或复发。入选标准为经组织学证实的非典型或间变性（恶性）脑膜瘤（世界卫生组织2级和3级），在初次切除或复发后接受分次EBRT治疗，年龄> 18岁。性别比（男性/女性）为1.3，平均（+/- SD）年龄为57.6 +/- 12岁。在71%的患者中，手术肉眼可见完成（Simpson 1-3级）;组织学分别为69%和31%的非典型和恶性。EBRT的平均剂量为54.6 +/- 5.1戈伊（范围，40-66戈伊）。结果：5年和10年的精算总生存率分别为65%和51%，在单变量分析中，年龄> 60岁（p = 0.005）、Karnofsky体能状态（KPS）（p = 0.01）和高有丝分裂率（p = 0.047）对生存率有显著影响。多变量分析显示，年龄> 60岁（p = 0.001）和高分裂率（p = 0.02）仍是显著的不良预后因素。单变量分析显示，5年和10年无病生存率分别为58%和48%，并且受到KPS（p = 0.04）和高有丝分裂率（p = 0.003）的显着影响。在多变量分析只有高有丝分裂率（p = 0.003）仍然是一个重要的预后factor.Conclusions：在这项多中心回顾性研究中，年龄，KPS，有丝分裂率影响的结果。多中心前瞻性研究是必要的，以澄清这种罕见疾病的管理和预后因素。(c)2008年爱思唯尔公司
Purpose: To retrospectively analyze and assess the outcomes and prognostic factors in a large number of patients with atypical and malignant meningiomas.Methods and Materials: Ten academic medical centers participating in this Rare Cancer Network contributed 119 cases of patients with atypical or malignant meningiomas treated with external beam radiotherapy (EBRT) after surgery or for recurrence. Eligibility criteria were histologically proven atypical or anaplastic (malignant) meningioma (World Health Organization Grade 2 and 3) treated with fractionated EBRT after initial resection or for recurrence, and age > 18 years. Sex ratio (male/female) was 1.3, and mean (+/- SD) age was 57.6 +/- 12 years. Surgery was macroscopically complete (Simpson Grades 1-3) in 71 % of patients; histology was atypical and malignant in 69 % and 31 %, respectively. Mean dose of EBRT was 54.6 +/- 5.1 Gy (range, 40-66 Gy). Median follow-up was 4.1 years.Results: The 5- and 10-year actuarial overall survival rates were 65 % and 51 %, respectively, and were significantly influenced by age > 60 years (p = 0.005), Karnofsky performance status (KPS) (p = 0.01), and high mitotic rate (p = 0.047) on univariate analysis. On multivariate analysis age > 60 years (p = 0.001) and high mitotic rate (p = 0.02) remained significant adverse prognostic factors. The 5- and 10-year disease-free survival rates were 58% and 48%, respectively, and were significantly influenced by KPS (p = 0.04) and high mitotic rate (p = 0.003) on univariate analysis. On multivariate analysis only high mitotic rate (p = 0.003) remained a significant prognostic factor.Conclusions: In this multicenter retrospective study, age, KPS, and mitotic rate influenced outcome. Multicenter prospective studies are necessary to clarify the management and prognostic factors of such a rare disease. (c) 2008 Elsevier Inc.