Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.
J Neurooncol. 2013 Nov;115(2):241-7. doi: 10.1007/s11060-013-1219-y. Epub 2013 Aug 15.
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.
本研究旨在分析治疗结果，并确定预测疾病进展的预后因素，重点关注辅助放疗（ART）的作用，以预测非典型脑膜瘤的疾病进展。1997 年至 2011 年间，共有 83 例脑膜瘤患者纳入本研究。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 治疗。作为主要治疗方法，27 例患者接受手术切除后接受 ART，56 例患者未接受辅助治疗。在 83 例可评估的患者中，55 例（66.3%）患者行完全切除。ART 的中位剂量为 61.2Gy，中位年龄为 52 岁。5 年和 10 年的总生存率分别为 90.2%和 62.0%，5 年和 10 年的无进展生存率（PFS）均为 48.0%，中位随访时间为 43.0 个月。ART 的添加（p=0.016）和完全肿瘤切除（p=0.002）与更好的 PFS 相关。根据切除状态和 ART 将患者分为四组后，未接受 ART 的不完全切除组的患者 PFS 明显差于其他三组（p<0.001）。总之，对于经 2000/2007 年 WHO 分类定义的非典型脑膜瘤患者，手术切除后行 ART 可降低局部肿瘤进展率。我们的结果可能有助于 ART 的常规应用，尤其是在不完全切除后，直到正在进行的前瞻性试验结果可用。
