脑膜黑色素细胞瘤的放疗作用——20 年随访结果。
The Role of Radiotherapy for Meningeal Melanocytomas - A 20 Year Update.
机构信息
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany;
Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Lübeck, Germany.
出版信息
In Vivo. 2024 May-Jun;38(3):1220-1228. doi: 10.21873/invivo.13558.
BACKGROUND/AIM: Meningeal melanocytomas are rare tumors of the central nervous system and optimal treatment needs further clarification. This study compared subtotal resection (STR), STR plus radiation therapy (RT), gross total resection (GTR), and GTR+RT to better define the role of postoperative RT.
PATIENTS AND METHODS
All cases reported in the literature were reviewed. Patients (n=184) with complete data were analyzed for local control (LC) and overall survival (OS).
RESULTS
On univariate analysis, GTR (vs. STR) was associated with improved LC (p=0.016). When comparing the treatment regimens, best and worst results were found after GTR+RT and STR alone, respectively (p<0.001). On univariate analysis, GTR resulted in better OS than STR (p=0.041). Moreover, the treatment regimen had a significant impact on OS (p=0.049). On multivariate analyses of LC and OS, extent of resection and treatment regimen were found to be significant factors. After STR, RT significantly improved LC but not OS. After GTR, RT did not significantly improve LC or OS.
CONCLUSION
GTR was significantly superior to STR regarding LC and OS. STR+RT resulted in significantly better LC when compared to STR alone.
背景/目的：脑脊膜黑色素细胞瘤是一种罕见的中枢神经系统肿瘤，其最佳治疗方法仍需进一步明确。本研究比较了次全切除术（STR）、STR 加放疗（RT）、大体全切除术（GTR）和 GTR+RT，以更好地确定术后 RT 的作用。
患者和方法
回顾了文献中报告的所有病例。对有完整数据的患者（n=184）进行局部控制（LC）和总生存（OS）分析。
结果
单因素分析显示，GTR（与 STR 相比）与改善 LC 相关（p=0.016）。当比较治疗方案时，GTR+RT 和 STR 单独治疗的结果最好和最差（p<0.001）。单因素分析显示，GTR 组的 OS 优于 STR 组（p=0.041）。此外，治疗方案对 OS 有显著影响（p=0.049）。LC 和 OS 的多因素分析显示，切除范围和治疗方案是显著因素。STR 后，RT 显著提高了 LC，但对 OS 没有显著影响。GTR 后，RT 对 LC 和 OS 均无显著影响。
结论
GTR 在 LC 和 OS 方面明显优于 STR。与 STR 相比，STR+RT 可显著提高 LC。
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