Effectiveness of Postoperative Radiotherapy on Atypical Meningioma Patients: A Population-Based Study
Effectiveness of Postoperative Radiotherapy on Atypical Meningioma Patients: A Population-Based Study
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非典型脑膜瘤患者术后放疗的有效性：一项基于人群的研究
DOI：
10.3389/fonc.2019.00034
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发表时间：
2019-01-31
影响因子：
4.7
通讯作者：
Guo, Zhige
中科院分区：
文献类型：
--
作者：
Zeng, Qiang;Shi, Feina;Guo, Zhige
目的：非典型性脑膜瘤患者接受大部全切除(GTR)后是否能从术后放疗(PORT)中获益，目前尚存争议。本研究旨在探讨PORT对不典型脑膜瘤患者的疗效。方法：从监测、流行病学和最终结果(SEER)数据库中提取2008-2015年间诊断为非典型脑膜瘤的患者。建立Kaplan-Meier生存曲线，组间比较采用对数等级检验。生存分析采用单因素和多因素COX回归分析。结果：共有1,014名患者入选。总的5年生存率为79.0%。315例(31.1%)患者行PORT。胃大部切除(STR)组和GTR组的PORT利用率分别为26.7%和42.2%。对于接受短暂性放射治疗的患者，LOG-RANK检验显示，接受PORT治疗的患者的总存活(OS)时间明显长于未接受PORT的患者(p=0.026)。对于接受移植物抗宿主病的患者，OS时间与PORT之间没有明显的相关性(p=0.339)。此外，PORT组和PORT组患者的OS时间无显著差异(p=0.398)。多变量COX回归分析显示，PORT(p=0.187)不是调整后OS的独立预测因素。结论：PORT可能不会延长不典型脑膜瘤患者的手术时间。然而，接受STR的患者可能会从PORT中受益，并实现与接受GTR的患者相似的OS。
Purpose: It is controversial whether atypical meningioma patients undergoing gross-total resection (GTR) can benefit from postoperative radiotherapy (PORT). This study aimed to investigate the effectiveness of PORT on atypical meningioma patients. Methods: Patients diagnosed with atypical meningioma from 2008 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier survival curves were generated, and the log-rank test was used to compare the differences among groups. Univariable and multivariable COX regressions were conducted for survival analyses. Results: A total of 1,014 patients were enrolled. The 5-years survival rate of the overall patients was 79.0%. PORT was performed in 315 (31.1%) patients. The utilization rates of PORT in patients undergoing GTR and undergoing subtotal resection (STR) were 26.7% and 42.2%, respectively. For patients undergoing STR, log-rank test showed that overall survival (OS) time was significantly longer in patients receiving PORT than those not (p = 0.026). For patients undergoing GTR, OS time did not show significant association with PORT (p = 0.339). In addition, patients undergoing STR with PORT had no significantly different OS time compared with those undergoing GTR with PORT (p = 0.398). Multivariable Cox regression analysis showed that receipt of PORT (p = 0.187) was not an independent predictor of OS after adjustment. Conclusion: PORT may not prolong the OS in atypical meningioma patients undergoing GTR. However, patients undergoing STR may benefit from PORT and achieve similar OS to those undergoing GTR.