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Adjuvant Radiotherapy Versus Surveillance for Grade 2 Intracranial Meningiomas: A Multi-Institutional Propensity Score-Matched Study.


ABSTRACT:

Purpose

We aimed to compare the outcomes of adjuvant radiotherapy (ART) and surveillance in patients with grade 2 meningiomas (MNG2) who underwent surgical resection.

Materials and methods

Data from four hospitals, in which patients aged ≥18 years underwent Simpson grade 1-4 surgical resection for newly diagnosed MNG2 between 1998 and 2018, were examined in this multicenter retrospective cohort study. Patients receiving ART with conventional fractionation were compared with those undergoing surveillance. Progression-free survival (PFS), progression/recurrence (P/R) were evaluated.

Results

This study included 518 patients, 158 of whom received ART. The median follow-up duration was 64.9 months. In the total cohort, ART was independently associated with significantly improved PFS (HR, 0.35; 95% CI, 0.23-0.55; P<0.001) and P/R (HR, 0.30; 95% CI, 0.18-0.48; P<0.001). In the propensity score-matched cohort (n=143 in each group), the 5-year PFS rates were 80.8% and 57.7% (P=0.004), and the 5-year P/R rates were 16.5% and 40.0% (P=0.002) in the ART and surveillance groups, respectively. After gross total resection, the 5-year PFS (85.0% vs. 64.7%; P=0.020) and P/R rates (15.2% vs. 32.0%; P=0.035) were significantly better in the ART group than in the surveillance group. A model for P/R was developed using recursive partitioning analysis with surgical extent, tumor size, and Ki-67 index. ART reduced the risk of P/R in the low- (P=0.069), intermediate- (P=0.044), and high-risk groups (P<0.001). Local control was also significantly enhanced by ART among all the risk groups (all P<0.05).

Conclusions

ART significantly improved PFS and P/R in patients with MNG2, irrespective of the surgical extent, and can be recommended after gross total resection. A prognostic model may guide decision-making for the use of ART.

SUBMITTER: Byun HK 

PROVIDER: S-EPMC9283569 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Adjuvant Radiotherapy Versus Surveillance for Grade 2 Intracranial Meningiomas: A Multi-Institutional Propensity Score-Matched Study.

Byun Hwa Kyung HK   Chang Won Ick WI   Lee Joo Ho JH   Park Chul-Kee CK   Kim In Ah IA   Kim Chae-Yong CY   Cho Jaeho J   Kim Eui Hyun EH   Chang Jong Hee JH   Kang Seok-Gu SG   Moon Ju Hyung JH   Lee Sang Hyung SH   Lee Jason Joon Bock JJB   Kim Il Han IH   Suh Chang-Ok CO   Wee Chan Woo CW   Yoon Hong In HI  

Frontiers in oncology 20220701


<h4>Purpose</h4>We aimed to compare the outcomes of adjuvant radiotherapy (ART) and surveillance in patients with grade 2 meningiomas (MNG2) who underwent surgical resection.<h4>Materials and methods</h4>Data from four hospitals, in which patients aged ≥18 years underwent Simpson grade 1-4 surgical resection for newly diagnosed MNG2 between 1998 and 2018, were examined in this multicenter retrospective cohort study. Patients receiving ART with conventional fractionation were compared with those  ...[more]

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