Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Acta Neurochir (Wien). 2021 Sep;163(9):2459-2464. doi: 10.1007/s00701-021-04797-0. Epub 2021 Mar 29.
The role of adjuvant radiotherapy after gross total resection (GTR) of WHO grade 2 meningioma remains unclear, and conflicting results have been published. We hypothesized that authors' medical specialties could be associated with reported findings on the role of adjuvant radiotherapy after GTR of WHO grade 2 meningiomas.
A systematic review was conducted in Embase and Medline databases, in addition to screening of all relevant bibliographies. Articles including patients aged 18 years or older, with histologically confirmed WHO grade 2 meningioma, were included. We extracted data on medical subspecialties using the author list. We registered study design, median follow-up, number of included patients, WHO classification in use, and years of study inclusion.
Thirty-seven relevant studies were identified, where 34 (92%) were retrospective cohort studies, two studies (5%) were systematic reviews, and one study (3%) was a meta-analysis. If the last author was a radiation-oncologist, the study was more likely to favor adjuvant radiotherapy, and if a neurosurgeon was last author, the study was more likely to not advocate adjuvant radiotherapy (p=0.009). There was no significant association between study result and whether the study was published in a neurosurgical or oncological journal (p=0.802). There was no significant difference in follow-up time, years of inclusion, or number of included patients between studies favoring or not favoring adjuvant radiotherapy.
In this systematic review of the literature, we found that if a radiation-oncologist was the last author of the study, the study was more likely to favor adjuvant radiotherapy after gross total resection of WHO grade 2 meningioma. Clinicians and researchers should be aware of a possible genealogy bias in the neuro-oncological literature.
在世界卫生组织（WHO）分级 2 型脑膜瘤行大体全切除（GTR）后辅助放疗的作用仍不明确，且已有相互矛盾的研究结果发表。我们假设作者的医学专业可能与 GTR 后 WHO 分级 2 型脑膜瘤辅助放疗作用的报告结果相关。
我们在 Embase 和 Medline 数据库中进行了系统评价，并对所有相关文献进行了筛选。纳入标准为：年龄≥18 岁、组织学证实为 WHO 分级 2 型脑膜瘤的患者。我们使用作者列表提取医学亚专业的数据。我们提取了研究设计、中位随访时间、纳入患者数量、使用的 WHO 分级以及研究纳入年份。
共确定了 37 项相关研究，其中 34 项（92%）为回顾性队列研究，2 项（5%）为系统评价，1 项（3%）为荟萃分析。如果最后一位作者是放射肿瘤学家，则研究更倾向于辅助放疗，如果最后一位作者是神经外科医生，则研究更倾向于不主张辅助放疗（p=0.009）。研究结果与研究是否发表在神经外科或肿瘤学杂志之间无显著关联（p=0.802）。支持或不支持辅助放疗的研究之间在随访时间、纳入年份或纳入患者数量方面无显著差异。
在这项文献系统评价中，我们发现如果放射肿瘤学家是研究的最后一位作者，那么该研究更倾向于支持 GTR 后行辅助放疗治疗 WHO 分级 2 型脑膜瘤。临床医生和研究人员应该意识到神经肿瘤学文献中可能存在谱系偏见。
