Kinetics of tumor size and peritumoral brain edema before, during, and after systemic therapy in recurrent WHO grade II or III meningioma
Kinetics of tumor size and peritumoral brain edema before, during, and after systemic therapy in recurrent WHO grade II or III meningioma
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DOI：
10.1093/neuonc/nov183
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发表时间：
2016-03-01
期刊：
影响因子：
15.9
通讯作者：
Preusser, Matthias
中科院分区：
文献类型：
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作者：
Furtner, Julia;Schoepf, Veronika;Preusser, Matthias
全身抗肿瘤治疗对复发性世界卫生组织 (WHO) II 级和 III 级脑膜瘤的疗效尚不清楚。我们对接受全身抗肿瘤治疗的复发性 WHO II 级和 III 级脑膜瘤患者进行了系列颅 MRI 回顾性多中心分析。计算所有病变的肿瘤体积和直径的生长率，以及水肿大小的变化率。我们确定了总共 34 名患者（23 名非典型脑膜瘤，11 名间变性脑膜瘤），总共 57 个脑膜瘤病灶，他们曾在 6 个欧洲机构接受过治疗。全身治疗包括贝伐珠单抗、细胞毒性化疗、生长抑素类似物和酪氨酸激酶抑制剂。总体而言，与开始全身治疗前相比，全身治疗期间肿瘤生长率下降了 51%，肿瘤直径下降了 51%，肿瘤体积增长率下降了 14%。在全身治疗期间，接受贝伐珠单抗治疗的患者脑膜瘤生长率下降最为明显，直径减少了 80%，体积增长了 59%。此外，在开始全身治疗后，仅在接受贝伐珠单抗治疗的患者中观察到瘤周水肿减少（-107%）。我们的数据表明，全身治疗可能在一定程度上抑制复发性 WHO II 级和 III 级脑膜瘤的生长。在我们的小队列中，贝伐珠单抗对肿瘤生长具有最明显的抑制作用，并且具有一定的抗水肿活性。需要前瞻性研究来更好地确定药物治疗在这种肿瘤类型中的作用。
The efficacy of systemic antineoplastic therapy on recurrent World Health Organization (WHO) grades II and III meningiomas is unclear.We performed a retrospective multicenter analysis of serial cranial MRI in patients with recurrent WHO II and III meningiomas treated with antineoplastic systemic therapies. Growth rates for tumor volume and diameter, as well as change rates for edema size, were calculated for all lesions.We identified a total of 34 patients (23 atypical, 11 anaplastic meningiomas) with a total of 57 meningioma lesions who had been treated at 6 European institutions. Systemic therapies included bevacizumab, cytotoxic chemotherapy, somatostatin analogues, and tyrosine kinase inhibitors. Overall, tumor growth rates decreased during systemic therapy by 51% for tumor diameter and 14% for tumor volume growth rates compared with the period before initiation of systemic therapy. The most pronounced decrease in meningioma growth rates during systemic therapy was evident in patients treated with bevacizumab, with a reduction of 80% in diameter and 59% in volume growth. Furthermore, a decrease in size of peritumoral edema after initiation of systemic therapy was exclusively observed in patients treated with bevacizumab (-107%).Our data indicate that systemic therapy may inhibit growth of recurrent WHO grades II and III meningiomas to some extent. In our small cohort, bevacizumab had the most pronounced inhibitory effect on tumor growth, as well as some anti-edematous activity. Prospective studies are needed to better define the role of medical therapies in this tumor type.