Winkler C, Dornfeld S, Schwarz R, Friedrich S, Baumann M
Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden.
Strahlenther Onkol. 1998 Dec;174(12):624-8. doi: 10.1007/BF03038510.
Retrospective assessment of the efficacy of radiation therapy for meningiomas with high risk for local recurrence.
Records of 67 patients with meningiomas treated from 1974 to 1995 at 2 centres were analyzed. Follow-up time ranged from 0.8 to 213 months (median: 61 months). Radiation therapy was given either after local failure or after biopsy or subtotal resection. The ratio between malignant (n = 20) and benign (n = 47) meningioma was 1:2.4. Median age of the patients was 55 years (7 to 77 years). Radiation treatment was given at 1.5 to 2 Gy per fraction to 36 to 79.5 Gy. Survival rates were calculated by the Kaplan-Meier method. Statistical comparisons were performed with the log-rank test and the Cox proportional hazards model. The Bonferroni method was used to correct for multiple comparisons.
Five- and 10-year disease-free survival rates were 82% +/- 5% (standard error) and 70% +/- 9%. Local control rates at 5 and 10 years were 78% +/- 5% and 68% +/- 9%. In uni- and multivariate analysis histology, sex, total dose and center showed no significant influence on the results. Patients age was significant for local control (univariate p = 0.02; multivariate p = 0.03) and disease-free survival (univariate/multivariate p = 0.04). The postoperative tumor burden had a significant influence of disease-free survival (multivariate p = 0.04). After Bonferroni correction no significant influence was observed. We did not observe late side effects, especially brain necrosis.
Despite of the negative selection of our patients we observed high survival- and local control rates after radiation therapy. This underscores the role of radiation therapy in the treatment of meningiomas with high risk of local failure.
回顾性评估放射治疗对局部复发高危脑膜瘤的疗效。
分析了1974年至1995年在2个中心接受治疗的67例脑膜瘤患者的记录。随访时间为0.8至213个月（中位数：61个月）。放射治疗在局部失败后、活检后或次全切除后进行。恶性脑膜瘤（n = 20）与良性脑膜瘤（n = 47）的比例为1:2.4。患者的中位年龄为55岁（7至77岁）。放射治疗每次分割剂量为1.5至2 Gy，总剂量为36至79.5 Gy。采用Kaplan-Meier法计算生存率。使用对数秩检验和Cox比例风险模型进行统计学比较。采用Bonferroni法校正多重比较。
5年和10年无病生存率分别为82%±5%（标准误）和70%±9%。5年和10年局部控制率分别为78%±5%和68%±9%。单因素和多因素分析显示，组织学、性别、总剂量和中心对结果无显著影响。患者年龄对局部控制（单因素p = 0.02；多因素p = 0.03）和无病生存（单因素/多因素p = 0.04）有显著影响。术后肿瘤负荷对无病生存有显著影响（多因素p = 0.04）。经Bonferroni校正后未观察到显著影响。我们未观察到晚期副作用，尤其是脑坏死。
尽管我们的患者存在负面选择，但放射治疗后仍观察到较高的生存率和局部控制率。这突出了放射治疗在治疗局部失败高危脑膜瘤中的作用。
