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DOI: 10.1055/s-0041-1735879
Adjuvant Radiotherapy in Grade II, Atypical Meningioma of the Skull Base
Funding D.P.B. is partially supported by the Nell W. and William S. Elkin Research Fellowship in Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, Georgia, United States.Abstract
Introduction Atypical meningiomas (AM) are meningiomas that are more aggressive than their grade-I counterparts and have a higher rate of recurrence. The effect of adjuvant radiotherapy (ART) on AM of the skull base is not defined.
Methods A retrospective review of all AM's of the skull base primarily resected at our institution from 1996 to 2018 was completed. ART was defined as radiotherapy (RT) that occurred within 6 months of initial resection, regardless of Simpson's grade. Minimum time length of follow-up after resection was 2 years. Statistical analysis was performed using SAS.
Results There were a total of 59 skull base–located (SBL) AMs resected at our institution from 1996 to 2018. The average age of our cohort was 53.2 years. Gross total resection, defined as Simpson's grades I to III resection, was achieved in 36 (61%) of cases. Thirty-five of 59 (59%) patients received ART. Recurrence was observed in 14 patients (24%), and mean time to recurrence was 63.8 months. Patients who received ART had a lower observed rate of recurrence (8 vs. 46%); however, time to recurrence was not significantly different between the two populations.
Conclusion We observe that AM in the skull base location have higher recurrence rates than we would expect from grade-I meningioma. These data suggest that ART may offer benefit to the overall observed frequency of recurrence of SBL AM; however, the time to recurrence between patients who received ART and those who did not was not statistically significant in survival analysis.
Publikationsverlauf
Eingereicht: 13. Juni 2021
Angenommen: 12. August 2021
Artikel online veröffentlicht:
21. September 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
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References
- 1 Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2011-2015. Neuro-oncol 2018; 20 (Suppl. 04) iv1-iv86
- 2 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016; 131 (06) 803-820
- 3 Rogers L, Gilbert M, Vogelbaum MA. Intracranial meningiomas of atypical (WHO grade II) histology. J Neurooncol 2010; 99 (03) 393-405
- 4 Rydzewski NR, Lesniak MS, Chandler JP. et al. Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma. Cancer 2018; 124 (04) 734-742
- 5 Kshettry VR, Ostrom QT, Kruchko C, Al-Mefty O, Barnett GH, Barnholtz-Sloan JS. Descriptive epidemiology of World Health Organization grades II and III intracranial meningiomas in the United States. Neuro-oncol 2015; 17 (08) 1166-1173
- 6 Aghi MK, Carter BS, Cosgrove GR. et al. Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation. Neurosurgery 2009; 64 (01) 56-60 , discussion 60
- 7 Kaur G, Sayegh ET, Larson A. et al. Adjuvant radiotherapy for atypical and malignant meningiomas: a systematic review. Neuro-oncol 2014; 16 (05) 628-636
- 8 Bagshaw HP, Burt LM, Jensen RL. et al. Adjuvant radiotherapy for atypical meningiomas. J Neurosurg 2017; 126 (06) 1822-1828
- 9 Hoffmann W, Mühleisen H, Hess CF. et al. Atypical and anaplastic meningiomas–does the new WHO-classification of brain tumours affect the indication for postoperative irradiation?. Acta Neurochir (Wien) 1995; 135 (3,4): 171-178
- 10 Zhi M, Girvigian MR, Miller MJ. et al. Long-term outcomes of newly diagnosed resected atypical meningiomas and the role of adjuvant radiotherapy. World Neurosurg 2019; 122: e1153-e1161
- 11 McGovern SL, Aldape KD, Munsell MF, Mahajan A, DeMonte F, Woo SY. A comparison of World Health Organization tumor grades at recurrence in patients with non-skull base and skull base meningiomas. J Neurosurg 2010; 112 (05) 925-933
- 12 Sade B, Chahlavi A, Krishnaney A, Nagel S, Choi E, Lee JH. World Health Organization grades II and III meningiomas are rare in the cranial base and spine. Neurosurgery 2007; 61 (06) 1194-1198 , discussion 1198
- 13 Ausman JI. A revolution in skull base surgery: the quality of life matters!. Surg Neurol 2006; 65 (06) 635-636
- 14 Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 1957; 21 (01) 22-39
- 15 Perry A, Stafford SL, Scheithauer BW, Suman VJ, Lohse CM. Meningioma grading: an analysis of histologic parameters. Am J Surg Pathol 1997; 21 (12) 1455-1465
- 16 Walcott BP, Nahed BV, Brastianos PK, Loeffler JS. Radiation treatment for WHO grade II and III meningiomas. Front Oncol 2013; 3: 227
- 17 Hashimoto N, Rabo CS, Okita Y. et al. Slower growth of skull base meningiomas compared with non-skull base meningiomas based on volumetric and biological studies. J Neurosurg 2012; 116 (03) 574-580
- 18 Mahmood A, Caccamo DV, Tomecek FJ, Malik GM. Atypical and malignant meningiomas: a clinicopathological review. Neurosurgery 1993; 33 (06) 955-963
- 19 Bray DP, Quillin JW, Press RH. et al. Adjuvant radiotherapy versus watchful waiting for World Health Organization grade II atypical meningioma: a single-institution experience. Neurosurgery 2021; 88 (05) E435-E442
- 20 Rogers L, Barani I, Chamberlain M. et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg 2015; 122 (01) 4-23
- 21 Rogers L, Zhang P, Vogelbaum MA. et al. Intermediate-risk meningioma: initial outcomes from NRG Oncology RTOG 0539. J Neurosurg 2018; 129 (01) 35-47
- 22 Weber DC, Ares C, Villa S. et al. Adjuvant postoperative high-dose radiotherapy for atypical and malignant meningioma: a phase-II parallel non-randomized and observation study (EORTC 22042-26042). Radiother Oncol 2018; 128 (02) 260-265
- 23 Jenkinson MD, Javadpour M, Haylock BJ. et al. The ROAM/EORTC-1308 trial: Radiation versus Observation following surgical resection of Atypical Meningioma: study protocol for a randomised controlled trial. Trials 2015; 16 (01) 519
- 24 Kane AJ, Sughrue ME, Rutkowski MJ. et al. Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer 2011; 117 (06) 1272-1278