J Korean Neurosurg Soc.  2017 Sep;60(5):527-533. 10.3340/jkns.2016.1111.009.

The Role of Adjuvant Treatment in Patients with High-Grade Meningioma

• Cho M
• Joo JD
• Kim IA
• Han JH
• Oh CW
• Kim CY

• KMID: 2457959
• DOI: http://doi.org/10.3340/jkns.2016.1111.009

Abstract

OBJECTIVE
To investigate the efficacy of adjuvant treatment in patients with high-grade meningioma.
METHODS
A retrospective analysis was performed for patients with high-grade meningioma, World Health Organization grade 2 or 3, in a single center between 2003 and 2014. The patients were reviewed according to age at diagnosis, sex, the location of meningioma, degree of tumor resection, histological features, and type of adjuvant treatment. These factors were analyzed by Firth logistic regression analyses.
RESULTS
Fifty-three patients with high-grade meningioma were enrolled. Thirty-four patients received adjuvant treatment; conventional radiotherapy or radiosurgery. Clinical follow-up ranged from 13-113 months with a median follow-up of 35.5 months. Gross total removal (GTR), Simpson grade 1 or 2, was achieved in 29 patients and, among them, 13 patients received adjuvant treatment. In the other 24 patients with non-GTR, conventional adjuvant radiotherapy and radiosurgery were performed in 11 and 10 patients, respectively. The other 3 patients did not receive any adjuvant treatment. Radiation-related complications did not occur. Of the 53 patients, 19 patients had suffered from recurrence. The recurrence rate in the adjuvant treatment group was 23.5% (8 out of 34). On the other hand, the rate for the non-adjuvant treatment group was 57.9% (11 out of 19) (odds ratio [OR]=0.208, p=0.017). In the GTR group, the recurrence rate was 7.5% (1 out of 13) for patients with adjuvant treatment and 50% (8 out of 16) for patients without adjuvant treatment (OR=0.121, p=0.04).
CONCLUSION
Adjuvant treatment appears to be safe and effective, and could lead to a lower recurrence rate in high-grade meningioma, regardless of the extent of removal. Our results might be used as a reference for making decisions when planning adjuvant treatments for patients with high-grade meningioma after surgery.

Keyword

Meningioma; Adjuvant radiotherapy; Radiosurgery

MeSH Terms

Diagnosis
Follow-Up Studies
Hand
Humans
Logistic Models
Meningioma*
Radiosurgery
Radiotherapy
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
World Health Organization

Figure

• 

  Fig. 1 Progression-free survival curve, according to the extent of removal. A: All patients. B: GTR group. C: STR group. GTR: gross total removal, STR: subtotal removal.

Reference

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