Analysis of prognostic factors and treatment of anaplastic meningioma in China
Analysis of prognostic factors and treatment of anaplastic meningioma in China
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我国间变性脑膜瘤的预后因素及治疗分析
DOI：
10.1016/j.jocn.2014.10.023
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发表时间：
2015-04-01
影响因子：
2
通讯作者：
Gong, Ye
中科院分区：
文献类型：
--
作者：
Zhu, Hongda;Xie, Qing;Gong, Ye
脑膜瘤是最常见的原发性脑和中枢神经系统肿瘤。然而，恶性脑膜瘤是罕见的与间变性亚型最常见的。脑膜瘤的这种亚型是致命的，复发率高，生存率低。对2003年至2008年在中国最大的神经外科中心之一治疗的间变性脑膜瘤患者进行了回顾性分析。在70名确定的患者中，有7名失访，但对其余63名患者进行了预后因素研究。平均随访时间为84.9 +/-标准差（SD）19.7个月。63例患者中35例（55.6%）肿瘤复发。33例（52.4%）患者在最近一次随访时死亡，中位总生存期（OS）为70.0 ± 9.7个月。3年和5年生存率分别为68.3%和54.7%。中位无进展生存期（PFS）为52.0 ± 9.9个月，而3年和5年PFS率分别为60.2%和43.9%。我们发现术前KPS评分、肿瘤切除范围、放射治疗、肿瘤部位和既往脑膜瘤病史是PFS的相关因素。在无复发组中，术前Kamofsky评分（KPS）、肿瘤切除程度和放疗与PFS相关。然而，多变量分析确定放疗是影响PFS的唯一独立因素（p = 0.007）。此外，MIB-1增殖指数未能确定预测间变性脑膜瘤预后的临界点。本研究提供了一个概述的流行病学和治疗的间变性脑膜瘤在中国使用的大量人口。(C)2014爱思唯尔有限公司版权所有。
Meningioma is the most frequently reported primary brain and central nervous system tumor. However, malignant meningioma is rare with the anaplastic subtype the most common. This subtype of meningioma is fatal with a high recurrence rate and poor survival. A retrospective review of anaplastic meningioma patients treated in one of the largest neurosurgical centers in China between 2003 and 2008 was conducted. From 70 identified patients, seven were lost to follow-up, but the remaining 63 patients were studied for prognostic factors. The mean follow-up time was 84.9 +/- standard deviation (SD) of 19.7 months. Tumor recurred in 35 out of 63 (55.6%) patients. Thirty-three (52.4%) patients had died by the most recent follow-up, and the median overall survival (OS) was 70.0 +/- 9.7 months. The 3 year and 5 year survival rates were 683% and 54.7%, respectively. The median progression-free survival (PFS) was 52.0 +/- 9.9 months, whereas the 3 year and 5 year PFS rates were 60.2% and 43.9%, respectively. We found that preoperative KPS, extent of tumor resection, radiotherapy, tumor location and previous history of meningioma were factors related to PFS. In the non-recurrent group, the preoperative Kamof-sky Performance Scale (KPS), extent of tumor resection and radiotherapy correlated with PFS. However, multivariate analysis identified radiotherapy as the only independent factor affecting PFS (p = 0.007). Additionally, MIB-1 proliferation index failed to identify a cut-off point to predict the prognosis for anaplastic meningioma. This study provides an overview of the epidemiology and treatment of anaplastic meningioma in China using a large population. (C) 2014 Elsevier Ltd. All rights reserved.