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Risk group-adapted adjuvant radiotherapy for WHO grade I and II skull base meningioma

Authors
 Sangjoon Park  ;  Yoon Jin Cha  ;  Sang Hyun Suh  ;  Ik Jae Lee  ;  Kyu-Sung Lee  ;  Chang-Ki Hong  ;  Jun Won Kim 
Citation
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, Vol.145(5) : 1351-1360, 2019 
Journal Title
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
ISSN
 0171-5216 
Issue Date
2019
MeSH
Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Male ; Meningioma/mortality ; Meningioma/pathology* ; Meningioma/radiotherapy* ; Meningioma/surgery ; Middle Aged ; Neoplasm Grading ; Prognosis ; Radiotherapy, Adjuvant/methods ; Recurrence ; Retreatment ; Retrospective Studies ; Skull Base Neoplasms/mortality ; Skull Base Neoplasms/pathology* ; Skull Base Neoplasms/radiotherapy* ; Skull Base Neoplasms/surgery ; Treatment Outcome ; Tumor Burden ; Young Adult
Keywords
Adjuvant radiotherapy ; Meningioma ; Risk factors ; Skull base neoplasm ; Surgical extent ; WHO grade I/II
Abstract
PURPOSE: Salvage treatment including surgery and radiotherapy (RT) for recurrent or progressive meningioma is not an easy task, especially for the skull base location. And yet, criteria for adjuvant radiotherapy after initial surgery are not clearly defined for WHO grade I/II meningioma. We determined prognostic factors for recurrence and evaluated the benefit of risk group-adapted adjuvant RT for WHO grade I/II meningioma in the skull base.

METHODS: We reviewed 272 patients who underwent surgery and were pathologically confirmed with WHO grade I or II skull base meningioma between January 2000 and July 2017. Subgroup analyses were performed for WHO grade I (259 patients) and WHO grade II (13 patients) meningiomas to evaluate the benefit of RT in each subgroup.

RESULTS: Patients with WHO grade II meningiomas tended to present more neurologic symptoms and to receive RT more frequently. In prognostic factor analysis, tumor size (p = 0.039), surgical extent (p < 0.001), and RT (p = 0.005) were associated with recurrence-free survival (RFS). In subgroup analysis of WHO grade I, RFS was significantly better in RT group after matching other variables. The risk stratification was performed using three risk factors (petroclival location, tumor size, Simpson grade) in WHO grade I patients, and significantly different RFS was observed according to the risk group in non-RT patients.

CONCLUSIONS: Tumor size, Simpson grade, and adjuvant RT were prognostic factors. The risk group-adapted approach can facilitate the selection of patients who may benefit from adjuvant RT for WHO grade I/II skull base meningiomas.
Full Text
https://link.springer.com/article/10.1007%2Fs00432-019-02891-6
DOI
10.1007/s00432-019-02891-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Lee, Kyu Sung(이규성)
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Cha, Yoon Jin(차윤진) ORCID logo https://orcid.org/0000-0002-5967-4064
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170013
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