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Dose-response relationship in patients with newly diagnosed atypical meningioma treated with adjuvant radiotherapy

Authors
 Dowook Kim  ;  Won Ick Chang  ;  Hwa Kyung Byun  ;  In Ah Kim  ;  Jaeho Cho  ;  Joo Ho Lee  ;  Hong In Yoon  ;  Chan Woo Wee 
Citation
 JOURNAL OF NEURO-ONCOLOGY, Vol.161(2) : 329-337, 2023-01 
Journal Title
JOURNAL OF NEURO-ONCOLOGY
ISSN
 0167-594X 
Issue Date
2023-01
MeSH
Dose-Response Relationship, Radiation ; Humans ; Meningeal Neoplasms* / radiotherapy ; Meningioma* / pathology ; Progression-Free Survival ; Radiotherapy, Adjuvant ; Retrospective Studies
Keywords
Adjuvant therapy ; Dose–response relationship ; Meningioma ; Radiotherapy
Abstract
PurposeThis study aimed to identify the radiation dose-response relationship in patients with newly diagnosed atypical meningioma (AM) treated with adjuvant radiotherapy (ART) using conventional fractionation. MethodsIn total, 158 patients who underwent surgery and ART between 1998 and 2018 were reviewed. Among these patients, 135 with complete information on radiotherapy (RT) dose/fractionation and pathological reports were analyzed. We entered RT dose as a continuous variable into the Cox regression model using penalized spline to allow for a nonlinear relationship between RT dose and events. Local control (LC), progression-free survival (PFS), and overall survival (OS) were evaluated. The corresponding biological equivalent dose in 2 Gy fractions (EQD2) was calculated using an alpha/beta ratio of 4 Gy. ResultsThe median follow-up duration was 56.0 months. The median ART dose delivered was 61.2 Gy in 24-34 daily fractions, corresponding to a median EQD2 of 59.16 Gy. In multivariate analysis, larger size and higher mitotic count were associated with significantly reduced LC (P < 0.001 and P = 0.002, respectively), PFS (P < 0.001 and P = 0.006, respectively), and OS (P = 0.006 and P = 0.001, respectively). Meanwhile, a higher RT dose was significantly associated with improved LC, PFS, and OS. Moreover, RT showed a dose-dependent effect on LC, PFS, and OS; local failure, tumor progression, and death were reduced by 12%, 12%, and 16%, respectively, per 1 Gy increase in the dose (EQD2). ConclusionThe dose of ART in AM has a dose-response relationship with LC and survival outcomes.
Full Text
https://link.springer.com/article/10.1007/s11060-022-04206-1
DOI
10.1007/s11060-022-04206-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Byun, Hwa Kyung(변화경) ORCID logo https://orcid.org/0000-0002-8964-6275
Wee, Chan Woo(위찬우)
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197828
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