Belanger Katherine, Ung Timothy H, Damek Denise, Lillehei Kevin O, Ormond D Ryan
Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
BMC Cancer. 2022 Apr 7;22(1):367. doi: 10.1186/s12885-022-09340-7.
High-grade and recurrent meningiomas are often treatment resistant and pose a therapeutic challenge after surgical and radiation therapy (RT) failure. Temozolomide (TMZ) is a DNA alkylating agent that appears to have a radiosensitizing effect when used in combination with RT and may be worthwhile in meningioma treatment. Thus, we investigated the potential efficacy of concomitant RT plus TMZ compared to historical controls of just RT used in the treatment of high-grade and recurrent meningiomas.
We performed a retrospective analysis of patients with meningioma treated at the University of Colorado with TMZ chemoradiation. Progression free survival (PFS) and overall survival (OS) were calculated from the start of chemoradiation to local recurrence or death, respectively.
Eleven patients (12 tumors) were treated with chemoradiation with a median follow-up of 41.5 months. There were two WHO grade 1, eight grade 2 and two grade 3 meningiomas. Three patients died during the follow-up period-one being disease related (11.1%). Two patients had meningioma recurrence-at 2.3 months (WHO grade 3), and 5.4 years (WHO grade 2). Three-year OS and PFS for grade 2 meningiomas were each 88%. Historical controls demonstrate a 3-year median OS and PFS of 83% and 75.8%, respectively.
Treatment options are limited for meningiomas after local failure. In this study, TMZ chemoradiation demonstrated no significant difference in PFS and OS in the treatment of grade 2 meningiomas compared to historic controls. Further study is warranted to find novel methods for the treatment of malignant and recurrent meningiomas.
高级别和复发性脑膜瘤通常对治疗耐药，在手术和放射治疗（RT）失败后构成治疗挑战。替莫唑胺（TMZ）是一种DNA烷化剂，与RT联合使用时似乎具有放射增敏作用，可能对脑膜瘤治疗有价值。因此，我们研究了同步RT加TMZ与仅使用RT的历史对照相比在治疗高级别和复发性脑膜瘤中的潜在疗效。
我们对科罗拉多大学接受TMZ放化疗的脑膜瘤患者进行了回顾性分析。无进展生存期（PFS）和总生存期（OS）分别从放化疗开始计算至局部复发或死亡。
11例患者（12个肿瘤）接受了放化疗，中位随访时间为41.5个月。有2例世界卫生组织（WHO）1级、8例2级和2例3级脑膜瘤。3例患者在随访期间死亡，其中1例与疾病相关（11.1%）。2例患者出现脑膜瘤复发，分别在2.3个月（WHO 3级）和5.4年（WHO 2级）。2级脑膜瘤的3年OS和PFS均为88%。历史对照显示3年中位OS和PFS分别为83%和75.8%。
局部治疗失败后脑膜瘤的治疗选择有限。在本研究中，与历史对照相比，TMZ放化疗在治疗2级脑膜瘤的PFS和OS方面无显著差异。有必要进一步研究以找到治疗恶性和复发性脑膜瘤的新方法。
