Haie-Meder C, Brunel P, Cioloca C, Meder J F, Borel C, Marsiglia H, Parker F, Schlienger M
Institut Gustave-Roussy, Villejuif, France.
Bull Cancer Radiother. 1995;82(1):35-9.
Between 1962 and 1986, 32 patients with intracranial meningiomas were referred to the Institut Gustave-Roussy for external radiotherapy either after incomplete surgery, or unfavorable histology (meningiosarcoma/anaplastic meningioma), or after recurrences. In the latter case, the mean time interval between the first surgery and the recurrence was 2 years (range: 1-6 years). Radiotherapy was performed using photons, electrons or mixed photons-electrons. The mean total dose was 48 Gy (range: 9-65 Gy) delivered in a mean time of 35 days with a 19 mean number of fractions. Radiotherapy was interrupted in three cases at 9 Gy-17 Gy-20 Gy because of neurological worsening. The actuarial 5-year survival was 64%. Among the 32 patients, 11 died, eight of tumoral progression or recurrence and three of other causes (one ovarian carcinoma, two unknown). Among the 21 alive patients, eight presented a recurrence; five of them could be reoperated on with two complete resections. None of the following factors were found to be of prognostic value on the survival nor on the recurrence occurrence: age, tumor location, first surgical resection type, and, in the group of patients treated at the time of recurrence, the quality of the surgery at the time of recurrence and the time interval between the first surgery and the recurrence. Only one factor was evidenced as of significant value on the recurrence as well as the 10-year survival: the total dose of irradiation with a 10-year survival rate of 74% for total doses higher than or equal to 47 Gy versus 14% when the total dose was lower than 47 Gy.
1962年至1986年间，32例颅内脑膜瘤患者因手术不彻底、组织学类型不佳（脑膜肉瘤/间变性脑膜瘤）或复发后被转诊至古斯塔夫-鲁西研究所接受外照射放疗。在后一种情况下，首次手术与复发之间的平均时间间隔为2年（范围：1 - 6年）。放疗采用光子、电子或光子 - 电子混合方式进行。平均总剂量为48 Gy（范围：9 - 65 Gy），在平均35天内给予，平均分割次数为19次。有3例患者在9 Gy - 17 Gy - 20 Gy时因神经功能恶化中断放疗。5年精算生存率为64%。在这32例患者中，11例死亡，8例死于肿瘤进展或复发，3例死于其他原因（1例卵巢癌，2例原因不明）。在21例存活患者中，8例出现复发；其中5例可再次手术，2例完全切除。未发现以下因素对生存或复发有预后价值：年龄、肿瘤位置、首次手术切除类型，以及在复发时接受治疗的患者组中，复发时手术的质量和首次手术与复发之间的时间间隔。只有一个因素被证明对复发以及10年生存率有显著价值：照射总剂量，当总剂量高于或等于47 Gy时，10年生存率为74%，而总剂量低于47 Gy时为14%。
