Peele K A, Kennerdell J S, Maroon J C, Kalnicki S, Kazim M, Gardner T, Malton M, Goodglick T, Rosen C
Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC, USA.
Ophthalmology. 1996 Nov;103(11):1761-6; discussion 1766-7. doi: 10.1016/s0161-6420(96)30430-2.
To determine whether postoperative radiation therapy decreases recurrence rates in subtotally excised and recurrent sphenoid wing meningiomas.
Patients with primary subtotally excised and recurrent sphenoid wing meningiomas who underwent surgery between 1981 and 1994 (n = 105) were prospectively followed for recurrence. Postoperative radiation was not recommended in patients who had complete excision; therefore, their recurrence rates were not evaluated in this study. Patients with malignant meningiomas also were excluded from analysis. Recurrence was defined as evidence of tumor growth on neuroimaging with or without clinical symptoms.
Follow-up information was available for 86 patients; 69 had primary subtotally excised tumors and 17 had recurrent tumors. Follow-up information was unavailable in the remaining 19 patients. Tumor location and histopathology, type of surgery performed, and patient sex and age were similar in the irradiated and nonirradiated subgroups. Postoperative irradiation was delivered to 31 patients with primary tumors and 11 with recurrent tumors; none of these 42 patients had recurrence during a mean observation period of 4.2 and 3.5 years, respectively. The nonirradiated group consisted of 38 patients with primary tumors and 6 with recurrent tumors; 16 of 18 patients who had primary meningiomas had a recurrence and 5 of 6 who had recurrent tumors had another relapse (mean interval between resection and recurrence, 4.4 years and 14 months, respectively).
Postoperative radiation appeared to delay recurrence in subtotally excised and recurrent sphenoid wing meningiomas during the time frame of this study.
确定术后放疗是否能降低次全切除及复发的蝶骨嵴脑膜瘤的复发率。
对1981年至1994年间接受手术的原发性次全切除及复发的蝶骨嵴脑膜瘤患者（n = 105）进行前瞻性随访以观察复发情况。对于全切的患者不建议术后放疗；因此，本研究未评估他们的复发率。恶性脑膜瘤患者也被排除在分析之外。复发定义为神经影像学显示有肿瘤生长，无论有无临床症状。
86例患者有随访信息；69例为原发性次全切除肿瘤患者，17例为复发肿瘤患者。其余19例患者无随访信息。放疗组和未放疗组在肿瘤位置、组织病理学、手术类型以及患者性别和年龄方面相似。31例原发性肿瘤患者和11例复发肿瘤患者接受了术后放疗；这42例患者在平均观察期分别为4.2年和3.5年期间均未复发。未放疗组包括38例原发性肿瘤患者和6例复发肿瘤患者；18例原发性脑膜瘤患者中有16例复发，6例复发肿瘤患者中有5例再次复发（切除与复发之间的平均间隔分别为4.4年和14个月）。
在本研究的时间范围内，术后放疗似乎可延迟次全切除及复发的蝶骨嵴脑膜瘤的复发。
