Krcek Reinhardt, Leiser Dominic, García-Marqueta Marta, Bolsi Alessandra, Weber Damien Charles
Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, 5232 Villigen, Switzerland.
Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland.
Cancers (Basel). 2023 Jun 7;15(12):3099. doi: 10.3390/cancers15123099.
The aim of this study was to assess the clinical outcome, including QoL, of patients with intracranial meningiomas WHO grade 1-3 who were treated with Pencil Beam Scanning Proton Therapy (PBS PT) between 1997 and 2022. Two hundred patients (median age 50.4 years, 70% WHO grade 1) were analyzed. Acute and late side effects were classified according to CTCAE version 5.0. Time to event data were calculated. QoL was assessed descriptively by the EORTC-QLQ-C30 and BN20 questionnaires. With a median follow-up of 65 months (range: 3.8-260.8 months) the 5 year OS was 95.7% and 81.8% for WHO grade 1 and grade 2/3, respectively ( < 0.001). Twenty (10%) local failures were observed. Failures occurred significantly ( < 0.001) more frequent in WHO grade 2 or 3 meningioma (WHO grade 1: = 7, WHO grade 2/3: = 13), in patients with multiple meningiomas ( = 0.005), in male patients ( = 0.005), and when PT was initiated not as upfront therapy ( = 0.011). There were no high-grade toxicities in the majority ( = 176; 88%) of patients. QoL was assessed for 83 (41.5%) patients and for those patients PT did not impacted QoL negatively during the follow-up. In summary, we observed very few local recurrences of meningiomas after PBS PT, a stable QoL, and a low rate of high-grade toxicity.
本研究的目的是评估1997年至2022年间接受笔形束扫描质子治疗（PBS PT）的世界卫生组织（WHO）1-3级颅内脑膜瘤患者的临床结局，包括生活质量（QoL）。分析了200例患者（中位年龄50.4岁，70%为WHO 1级）。根据美国国立癌症研究所不良事件通用术语标准（CTCAE）第5.0版对急性和晚期副作用进行分类。计算事件发生时间数据。通过欧洲癌症研究与治疗组织生活质量核心问卷（EORTC-QLQ-C30）和BN20问卷对生活质量进行描述性评估。中位随访65个月（范围：3.8-260.8个月），WHO 1级和2/3级患者的5年总生存率分别为95.7%和81.8%（P<0.001）。观察到20例（10%）局部复发。WHO 2级或3级脑膜瘤（WHO 1级：n = 7，WHO 2/3级：n = 13）、多发脑膜瘤患者（P = 0.005）、男性患者（P = 0.005）以及质子治疗并非作为初始治疗开始时（P = 0.011），复发明显更频繁（P<0.001）。大多数患者（n = 176；88%）未出现高级别毒性反应。对83例（41.5%）患者进行了生活质量评估，在随访期间，质子治疗对这些患者的生活质量没有产生负面影响。总之，我们观察到笔形束扫描质子治疗后脑膜瘤的局部复发极少、生活质量稳定且高级别毒性发生率低。
