Poulen G, Vignes J-R, Le Corre M, Loiseau H, Bauchet L
Department of neurosurgery, Gui de Chauliac hospital, Montpellier university medical center, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
Department of neurosurgery, Pellegrin hospital, Bordeaux university medical center, Bordeaux, France.
Neurochirurgie. 2020 Apr;66(2):73-79. doi: 10.1016/j.neuchi.2019.12.008. Epub 2020 Mar 4.
Meningioma is the most common primary intracranial tumor, representing 13-36.6% of all primary central nervous system tumors. Meningiomas are benign in about 90% of cases. World Health Organization (WHO) grade II meningioma is associated with a high rate of recurrence and poorer survival than in grade I. The reference treatment is surgery, which should be as complete as possible. Currently, in grade II, there are no recommendations for systematic adjuvant treatment such as radiotherapy. We studied a homogeneous series of grade II meningiomas treated by surgery in two university hospital centers to analyze use of radiotherapy and its efficacy.
We retrospectively analyzed patients in our database with WHO grade II meningioma, operated on between 2007 and 2010 in the university hospitals of Montpellier and Bordeaux, France. Clinical and radiological data, treatments and survival were analyzed.
Eighty-eight patients were included. Five-year overall survival was 89.7%. Nineteen patients received radiotherapy during follow-up, without significant impact on survival (P=0.27).
In WHO grade II meningioma, it is currently difficult to establish clear recommendations for radiotherapy. The present study is in accordance with the literature that early postoperative radiotherapy is not mandatory in grade II meningioma with macroscopically total resection.
脑膜瘤是最常见的原发性颅内肿瘤,占所有原发性中枢神经系统肿瘤的13% - 36.6%。约90%的脑膜瘤为良性。世界卫生组织(WHO)二级脑膜瘤的复发率高,生存率低于一级。参考治疗方法是手术,手术应尽可能彻底。目前,对于二级脑膜瘤,尚无关于放疗等系统性辅助治疗的推荐。我们研究了在两个大学医院中心接受手术治疗的一组同质的二级脑膜瘤病例,以分析放疗的使用情况及其疗效。
我们回顾性分析了法国蒙彼利埃和波尔多大学医院2007年至2010年间手术治疗的WHO二级脑膜瘤患者的数据库。分析了临床和放射学数据、治疗方法及生存率。
纳入88例患者。五年总生存率为89.7%。19例患者在随访期间接受了放疗,对生存率无显著影响(P = 0.27)。
对于WHO二级脑膜瘤,目前难以制定明确的放疗推荐。本研究与文献一致,即对于肉眼全切的二级脑膜瘤,术后早期放疗并非必需。