LONG-TERM EXPERIENCE WITH WORLD HEALTH ORGANIZATION GRADE III (MALIGNANT) MENINGIOMAS AT A SINGLE INSTITUTION
LONG-TERM EXPERIENCE WITH WORLD HEALTH ORGANIZATION GRADE III (MALIGNANT) MENINGIOMAS AT A SINGLE INSTITUTION
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DOI：
10.1016/j.ijrobp.2008.08.018
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发表时间：
2009-06-01
影响因子：
7
通讯作者：
Suh, John H.
中科院分区：
文献类型：
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作者：
Rosenberg, Lewis A.;Prayson, Richard A.;Suh, John H.
目的：为了评估由2007年世界卫生组织standards.Methods和Materials定义的III级脑膜瘤患者的结局：由一位神经病理学家对在克利夫兰诊所接受恶性脑膜瘤治疗的患者的载玻片进行了审查。1984年至2006年治疗的13例患者的数据符合世界卫生组织2007年对III级脑膜瘤的定义。共进行了24例手术，包括13例初次手术，7例挽救手术和4例二次挽救手术。此外，14个疗程的放射治疗（RT），包括3例初次手术后的分次RT，4例挽救手术后的分次RT，3例患者的6个不同区域的挽救立体定向放射外科治疗，1例患者的挽救调强RT。从初次手术开始，中位生存期为3.4年，5年生存率为47.2%，8年生存率为12.2%。中位复发时间为9.6个月。与单纯手术治疗的患者相比，初次手术后接受辅助RT的患者生存期有延长的趋势。两名患者发生放射性坏死，三个有手术并发症。结论：这是少数几个研究报告的结果，恶性脑膜瘤患者根据最近的定义。我们的结果与现有的非典型和恶性脑膜瘤患者总体预后不良的报告一致。根据现有数据，手术切除后进行RT和挽救治疗可延长生存期。(C)2009爱思唯尔公司
Purpose: To evaluate the outcomes for patients with Grade III meningiomas as defined by the 2007 World Health Organization standards.Methods and Materials: The slides from patients who had been treated at the Cleveland Clinic for malignant meningiomas were reviewed by a single neuropathologist. The data from 13 patients treated between 1984 and 2006 satisfied the World Health Organization 2007 definition of Grade III meningioma. A total of 24 surgeries were performed, including 13 primary, 7 salvage, and 4 second salvage. Also, 14 courses of radiotherapy (RT) were administered, including fractionated RT in 3 patients after primary surgery, fractionated RT in 4 patients after salvage surgery, salvage stereotactic radiosurgery to six separate areas in 3 patients, and salvage intensity-modulated RT in 1 patient.Results: From the primary surgery, the median survival was 3.4 years, the 5-year survival rate was 47.2%, and the 8-year survival rate was 12.2%. The median time to recurrence was 9.6 months. A trend was seen toward longer survival for patients who had received adjuvant RT after initial surgery compared with those treated with surgery alone. Two patients developed radiation necrosis, and three had surgical complications.Conclusion: This is one of the few studies reporting the outcomes for malignant meningioma patients according to recent definitions. Our results are consistent with existing reports of the overall poor outcomes for atypical and malignant meningioma patients. From the available data, surgical resection followed by RT and salvage therapy can lead to extended survival. (C) 2009 Elsevier Inc.