Abstract:
PURPOSE:To analyze patterns of failure according to treatment modalities and evaluate the adequacy of an institution's current volume of postoperative radiotherapy (PORT) for World Health Organization (WHO) grade II or III meningiomas. PATIENTS AND METHODS:Data of 98 patients treated by either surgery and PORT (PORT group, n = 53) or surgery alone (surgery group, n = 45) between March 2000 and December 2013 were reviewed. Clinical target volume of PORT was delineated as a 1.5-2-cm expansion from the tumor bed. Local failure (LF) was defined as recurrence within a 2-cm margin from the tumor bed. Failures other than LF were defined as out-field failure (OFF). Median total dose of PORT was 59.4 (range 45.0-69.0) Gy. RESULTS:The PORT group had larger proportions of grade III meningiomas (18/53, 34.0%) than the surgery group (8/46, 15.6%) (p = 0.037). After a median 73.4-month follow-up, 29 patients experienced LF and 5 developed OFF. The actuarial 5-year local control (LC) rates were 86.7% and 59.3% in the PORT and surgery groups, respectively (p = 0.002). PORT was a significant factor of LC in the univariate (p = 0.003, hazard ratio [HR] 3.449, 95% confidence interval [CI] 1.516-7.846) and multivariate analyses (p < 0.001, HR 5.486, 95% CI 2.178-13.820). CONCLUSIONS:Despite the larger proportion of grade III meningiomas in the PORT group, PORT reduced LF in patients with WHO grade II or III meningiomas compared with the surgery group. The current PORT field seems reasonable because LF was the dominant pattern of failure in patients treated by surgery alone.
journal_name
J Neurooncoljournal_title
Journal of neuro-oncologyauthors
Lee JJB,Lee J,Yoon HI,Kim SH,Cho J,Lee KS,Chang JH,Suh COdoi
10.1007/s11060-019-03232-wsubject
Has Abstractpub_date
2019-09-01 00:00:00pages
333-341issue
2eissn
0167-594Xissn
1573-7373pii
10.1007/s11060-019-03232-wjournal_volume
144pub_type
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abstract:BACKGROUND:Based on limited literature, an at risk group of patients for development of neoplastic meningitis (NM) are those with resected cerebellar parenchymal metastases. OBJECTIVE:Characterize the incidence of NM in patients with cerebellar metastases treated with either surgical resection or radiotherapy. PATIEN...
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析
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abstract::Chordoid is a rare variant of meningioma that displays a high recurrence rate. In this study we evaluated the immunohistochemical expression of factors that regulate the neo-angiogenesis process in a case of chordoid meningioma with an adverse clinical course. A high microvessel density (MVD), as well as high VEGF and...
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