Prognostic Model That Predicts Benefits of Adjuvant Radiotherapy in Patients With High Grade Meningioma.
Prognostic Model That Predicts Benefits of Adjuvant Radiotherapy in Patients With High Grade Meningioma.
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预测高级别脑膜瘤患者辅助放疗益处的预后模型
DOI：
10.3389/fonc.2020.568079
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发表时间：
2020
影响因子：
4.7
通讯作者：
Gong Y
中科院分区：
文献类型：
--
作者：
Wang D;Sun S;Hua L;Deng J;Luan S;Cheng H;Xie Q;Wakimoto H;Zhu H;Gong Y
辅助放疗是高级别脑膜瘤手术切除后的主要治疗方式；然而，复发情况和生存结果各不相同。本研究的目的是创建一种新的“预后评分”，以便为高级别脑膜瘤患者的术后辅助放疗提供个性化建议。
从115例接受手术切除和辅助放疗的高级别脑膜瘤患者中收集临床数据。基于多变量Cox比例分析得出的独立预后因素的风险比构建预后模型。分别使用拟合优度检验和Harrel’s C指数评估预后评分的校准和判别能力。
共纳入115例高级别脑膜瘤患者（72例非典型脑膜瘤和43例间变性脑膜瘤）。三个因素与无进展生存期（PFS）独立相关：切除范围（全切除与次全切除）、复发状态（初发与复发）以及Ki - 67标记指数（<5%与≥5%）。各自的β系数用于生成“预后评分”。根据预后评分的中位数将队列分为低风险组和高风险组。拟合优度检验显示校准良好（P = 0.7133），Harrel’s C指数为0.766，表明预后评分具有较强的判别能力。总生存期（OS）的Harrel’s C指数为0.60。
我们使用三个基本临床参数的预后模型有力地将从辅助放疗中获益和未获益的高级别脑膜瘤患者区分开来。有必要对我们的模型进行外部验证，以帮助改进适合辅助放疗的患者选择。
Adjuvant radiotherapy is the main treatment modality for high grade meningioma after surgical resection; however, recurrence and survival outcomes vary. The aim of this study was to create a new “prognostic score” that allows personalized recommendations for post-operative adjuvant radiotherapy in patients with high grade meningioma. Clinical data were collected from 115 patients with high grade meningioma treated with surgical resection and adjuvant radiotherapy. A prognostic model was built based on the hazards ratios of independent prognostic factors yielded by multivariate cox proportional analysis. Calibration and discrimination of the prognostic score was evaluated using good of fit test and Harrel’s C index, respectively. A total of 115 high grade meningioma patients (72 atypical and 43 anaplastic meningiomas) were enrolled. Three factors were independently associated with progression-free survival (PFS): extent of resection (GTR vs. STR), recurrent status (de novo vs. recurrent), and Ki-67 labeling index (<5% vs. ≥ 5%). The respective β-coefficients were used to generate the “prognostic score”. The cohort was divided into low-risk and high-risk groups based on the median prognostic score. Good of fit test showed strong calibration (P = 0.7133) and Harrel’s C index 0.766 indicated a strong discrimination capability of the prognostic score. The Harrel’s C index for OS was 0.60. Our prognostic model using three basic clinical parameters robustly separated high grade meningioma patients who benefit vs. do not benefit from adjuvant radiotherapy. External validation of our model is warranted to help improve patient selection suitable for adjuvant radiotherapy.
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影响因子：
4.1
作者：
Shakir, Shakir I.;Souhami, Luis;Guiot, Marie-Christine
通讯作者：
Guiot, Marie-Christine
影响因子：
3.9
作者：
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作者：
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DOI：
10.1016/j.ijrobp.2011.08.010
发表时间：
2012-07-01
影响因子：
7
作者：
Adeberg, Sebastian;Hartmann, Christian;Combs, Stephanie E.
通讯作者：
Combs, Stephanie E.
DOI：
10.1016/j.ijrobp.2008.10.053
发表时间：
2009-10-01
影响因子：
7
作者：
Boskos, Christos;Feuvret, Loic;Mazeron, Jean-Jacques
通讯作者：
Mazeron, Jean-Jacques