The role of adjuvant radiotherapy in atypical meningioma
The role of adjuvant radiotherapy in atypical meningioma
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DOI：
10.1007/s11060-013-1219-y
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发表时间：
2013-11-01
影响因子：
3.9
通讯作者：
Jung, Hee-Won
中科院分区：
文献类型：
--
作者：
Park, Hae Jin;Kang, Hyun-Cheol;Jung, Hee-Won
本研究的目的是分析治疗结果并确定预后因素，重点关注辅助放疗 (ART) 的作用，预测非典型脑膜瘤的疾病进展。从1997年到2011年，83名脑膜瘤患者被纳入本研究。所有患者均经组织学证实为非典型脑膜瘤，并接受手术切除联合或不联合ART进行治疗。作为主要治疗，27 名患者接受了手术切除，随后接受了 ART，56 名患者未接受辅助治疗。在 83 名可评估的患者中，55 名 (66.3%) 患者接受了完全切除。中位 ART 剂量为 61.2 Gy，中位年龄为 52 岁。 5年和10年精算总生存率分别为90.2%和62.0%，5年和10年无进展生存率（PFS）均为48.0%，中位随访时间为43.0个月。添加 ART (p = 0.016) 和完整肿瘤切除 (p = 0.002) 与优异的 PFS 相关。当根据切除状态和 ART 分层为四组时，不完全切除且未接受 ART 的患者组的 PFS 显着低于其他三组 (p < 0.001)。总之，手术切除后接受 ART 可以降低 2000/2007 年更新的 WHO 分类所定义的非典型脑膜瘤患者的局部肿瘤进展。我们的结果可能有助于 ART 的常规使用，特别是在不完全切除后，直到正在进行的前瞻性试验的结果出来。
The object of this study was to analyze treatment outcomes and to identify the prognostic factors, with a focus on the role of adjuvant radiotherapy (ART), predicting disease progression in atypical meningiomas. From 1997 to 2011, 83 patients with meningioma were included in this study. All patients were histologically confirmed as atypical meningioma and were treated with surgical resection with or without ART. As primary therapy, 27 patients received surgical resection followed by ART, and 56 received no adjuvant therapy. Of 83 evaluable patients, 55 (66.3 %) patients underwent complete resection. The median ART dose was 61.2 Gy and their median age was 52 years. The 5- and 10-year actuarial overall survival rates were 90.2 and 62.0 %, and the 5- and 10-year progression-free survival (PFS) rates were both 48.0 %, with a median follow-up of 43.0 months. Addition of ART (p = 0.016) and complete tumor resection (p = 0.002) were associated with superior PFS. When stratified to four groups according to resection status and ART, the groups of patient with incomplete resection without ART showed significantly worse PFS compared to other three groups (p < 0.001). In conclusion, surgical resection followed by ART led to lower local tumor progression in patients with atypical meningioma defined by the updated 2000/2007 WHO classification. Our results may contribute to the routine use of ART, especially after incomplete resection, until the outcomes of ongoing prospective trials are available.