Yamanaka Ryuya, Hayano Azusa, Kanayama Tomohiko
Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
Laboratory of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
World Neurosurg. 2017 Jan;97:635-644.e8. doi: 10.1016/j.wneu.2016.09.094. Epub 2016 Oct 3.
Radiation-induced meningioma (RIM) is an uncommon late risk of cranial irradiation. We conducted an exhaustive review of individual patient data to characterize RIM.
Using a systematic search of the PubMed database, we performed a comprehensive literature review to characterize and investigate RIM. Student t tests were used to evaluate differences between variables. A Kaplan-Meier analysis was used to assess survival. Statistical significance was assessed using a log-rank test.
Our analysis included 251 cases of RIM. The average age at onset for the primary lesion was 13.0 ± 13.5 years, and the average radiation dose delivered to this lesion was 38.8 ± 16.8 Gy. Secondary meningiomas could be divided into grades I (140), II (55), and III (10) tumors. Thirty patients (11.9%) had multiple lesions, and 46 (18.3%) had recurrent meningiomas. The latency period between radiotherapy for primary lesions and the onset of meningiomas was 22.9 ± 11.4 years. The latency period was shorter for patients with grade III meningioma and for those in the high-dose and intermediate-dose radiation groups who received systemic chemotherapy. Aggressive meningiomas and multiple meningiomas were more common in the high-dose and intermediate-dose groups than in the low-dose group. The 5-year and 10-year survival rates for all patients with meningioma were 77.7% and 66.1%, respectively.
For patients treated with cranial radiotherapy, the risk of secondary meningioma warrants a longer follow-up period beyond the standard time frame typically designated for determining the risk of primary tumor relapse.
放射性诱发的脑膜瘤（RIM）是颅脑照射后一种罕见的晚期风险。我们对个体患者数据进行了详尽回顾，以描述RIM的特征。
通过对PubMed数据库进行系统检索，我们开展了一项全面的文献综述，以描述和研究RIM。采用学生t检验评估变量之间的差异。使用Kaplan-Meier分析评估生存率。采用对数秩检验评估统计学显著性。
我们的分析纳入了251例RIM病例。原发性病变的平均发病年龄为13.0±13.5岁，该病变接受的平均辐射剂量为38.8±16.8 Gy。继发性脑膜瘤可分为I级（140例）、II级（55例）和III级（10例）肿瘤。30例患者（11.9%）有多处病变，46例（18.3%）有复发性脑膜瘤。原发性病变放疗与脑膜瘤发病之间的潜伏期为22.9±11.4年。III级脑膜瘤患者以及接受全身化疗的高剂量和中剂量辐射组患者的潜伏期较短。侵袭性脑膜瘤和多发性脑膜瘤在高剂量和中剂量组比在低剂量组更常见。所有脑膜瘤患者的5年和10年生存率分别为77.7%和66.1%。
对于接受颅脑放疗的患者，继发性脑膜瘤的风险需要在通常用于确定原发性肿瘤复发风险的标准时间框架之外进行更长时间的随访。
