Klungtvedt Vanessa, Aunan-Diop Jan Saip, Poulsen Frantz Rom, Pedersen Christian Bonde, Wismann Joakim, Wang Eric W, Dahlrot Rikke Hedegaard, Halle Bo
Odense University Hospital, Department of Neurosurgery, Odense, Denmark.
Odense University Hospital, Department of Neurosurgery, Odense, Denmark; BRIDGE, University of Southern Denmark, Odense, Denmark.
World Neurosurg. 2025 May;197:123858. doi: 10.1016/j.wneu.2025.123858. Epub 2025 Mar 5.
To evaluate the efficacy of radiotherapy (RT) for World Health Organization (WHO) grade 1 and 2 intracranial meningiomas, focusing on the impact of postsurgical tumor volume on treatment outcomes.
Adult patients (aged ≥18 years) with WHO grade 1 or 2 intracranial meningiomas who received RT between January 1, 2019 and April 1, 2022 were identified. Exclusion criteria encompassed known extracranial tumors, preoperative RT or chemotherapy, and insufficient RT modality data. Patients were treated according to the international guidelines. Tumor recurrence was identified on magnetic resonance imaging with a follow-up period until April 2024. Kaplan-Meier estimates for progression-free survival (PFS) calculations and Cox proportional hazard models were performed to evaluate the impact of tumor volume and other covariates on PFS.
Among 113 patients with intracranial meningiomas who received RT, 103 met the inclusion criteria. Of these, 84.5% received photon-based and 15.5% proton-based treatment. The cohort was predominantly female (72.8%) with a mean age of 59 years. The 2-year and 5-year PFS rates were 95.6% and 90% for grade 1 tumors, respectively, and 83.3% for grade 2 tumors. Tumors >21 cm postsurgical pre-RT had a significantly higher risk of progression (hazard ratio = 4.35; P = 0.006).
Tumor volume was identified as a key prognostic factor for PFS in WHO grade 1 and 2 intracranial meningiomas treated with RT. A critical postsurgical volume threshold of 21 cm significantly influences 2-year and 5-year PFS rates, with patients exceeding this threshold experiencing a 335% increase in risk of progression.
评估放射治疗（RT）对世界卫生组织（WHO）1级和2级颅内脑膜瘤的疗效，重点关注术后肿瘤体积对治疗结果的影响。
确定2019年1月1日至2022年4月1日期间接受RT治疗的WHO 1级或2级颅内脑膜瘤成年患者（年龄≥18岁）。排除标准包括已知的颅外肿瘤、术前RT或化疗以及RT方式数据不足。患者按照国际指南进行治疗。通过磁共振成像确定肿瘤复发，随访至2024年4月。进行无进展生存期（PFS）计算的Kaplan-Meier估计和Cox比例风险模型，以评估肿瘤体积和其他协变量对PFS的影响。
在113例接受RT治疗的颅内脑膜瘤患者中，103例符合纳入标准。其中，84.5%接受基于光子的治疗，15.5%接受基于质子的治疗。该队列以女性为主（72.8%），平均年龄59岁。1级肿瘤的2年和5年PFS率分别为95.6%和90%，2级肿瘤为83.3%。术后放疗前肿瘤体积>21 cm的患者进展风险显著更高（风险比=4.35；P=0.006）。
肿瘤体积被确定为接受RT治疗的WHO 1级和2级颅内脑膜瘤PFS的关键预后因素。21 cm的关键术后体积阈值显著影响2年和5年PFS率，超过该阈值的患者进展风险增加335%。
