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Radiotherapy after surgery for benign cerebral meningioma.

机译:良性脑膜瘤手术后的放疗。

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BACKGROUND AND PURPOSE: To compare the outcome from adjuvant and delayed radiotherapy (RT) after surgery in patients with benign cerebral meningioma. PATIENTS AND METHODS: Between March 1953 and January 2001, 92 patients with benign cerebral meningioma (WHO grade I) were treated with surgery. Forty-eight patients underwent gross total resection (GTR), and 44 patients underwent subtotal resection (STR). Treatments were classified as GTR (n = 48), STR+adjuvant RT (n = 12), STR alone (n = 32). The prognostic factors were assessed as, gender, the Karnofsky performance score (KPS) (> or =90 vs. <90), the extent of surgery, and adjuvant or delayed RT. The endpoints analyzed were progression-free survival (PFS) and overall survival (OS). Overall survival curve of the study population is compared with the age-adjusted expected survival curve for the US population born in 1970. RESULTS: The median follow-up was 7.7 years. The 5-year PFS and OS rates for all patients were 65 and 93%, respectively. The 5-year PFSrates in patients treated with GTR and STR were 77 and 52%, respectively (P = 0.02). Patients treated with STR+adjuvant RT had significantly better PFS (91%) at 5 years than with STR alone (38%) (P = 0.0005). Gender showed no statistically significant impact on either PFS or OS (P > 0.05). However, multivariate analysis showed the KPS to have a statistically significant effect on OS (P = 0.02). The OS rate was the same across all three treatment groups. The age-adjusted expected survival curve for the US population born in 1970 lay within the confidence intervals for the overall survival curve of the study population. CONCLUSIONS: Although OS was not affected, adjuvant RT appeared to significantly reduce tumor progression. However, only a prospective randomized trial can adequately determine whether adjuvant or delayed radiotherapy is the better approach in patients with subtotally resected benign meningioma.
机译:背景与目的:比较良性脑膜瘤患者手术后辅助和延迟放疗的结果。患者与方法:从1953年3月至2001年1月,对92例良性脑膜瘤(WHO I级)患者进行了手术治疗。 48例患者行了全切术(GTR),44例患者进行了大肠切除术(STR)。治疗分为GTR(n = 48),STR +辅助RT(n = 12),仅STR(n = 32)。预后因素包括性别,卡诺夫斯基绩效评分(KPS)(>或= 90 vs. <90),手术程度以及辅助或延迟放疗。分析的终点为无进展生存期(PFS)和总体生存期(OS)。将研究人群的总体生存曲线与1970年出生的美国人群的年龄校正后的预期生存曲线进行比较。结果:中位随访时间为7.7年。所有患者的5年PFS和OS率分别为65%和93%。接受GTR和STR治疗的患者的5年PFS率分别为77%和52%(P = 0.02)。接受STR +辅助放疗的患者在5年时的PFS(91%)明显优于单纯接受STR的患者(38%)(P = 0.0005)。性别对PFS或OS均无统计学意义(P> 0.05)。但是,多变量分析显示KPS对OS具有统计学上的显着影响(P = 0.02)。在所有三个治疗组中,OS率均相同。 1970年出生的美国人口的年龄调整后的预期生存曲线位于研究人群总体生存曲线的置信区间内。结论:尽管OS没有受到影响,但辅助RT似乎可以显着降低肿瘤的进展。但是,只有一项前瞻性随机试验才能充分确定在大部切除的良性脑膜瘤患者中,辅助治疗还是延迟放疗是更好的方法。

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