Purpose

To assess the progression-free survival benefits of adjuvant radiotherapy (ART) following surgical resection compared to surgery alone in high-grade meningioma patients.

Methods

We retrospectively identified 43 patients with atypical meningiomas, who underwent either radiotherapy post-surgical resection (Surgery+ART) or surgery alone (Surgery alone) at our institution between February 2007 to March 2019. GTR was achieved in 28 patients, and STR, in 11. Patient, meningioma, and treatment data were extracted from records and compared using Kaplan-Meier methodology, log-rank tests, and Cox proportional hazard models. Radiation complications were also evaluated.

Results

Overall 32.6% (n = 14) of patients, 6 patients in the Surgery+ART group and 8 in the Surgery alone group, experienced recurrence. In the Surgery+ART group, the median PFS time was 46.5 months (CI: [35.8–50.6]), compared to 24.5 months (CI: [18.3–32.9]) in the Surgery alone group. 2-year PFS for Surgery+ART was 100% vs. 69.0% for Surgery alone, and the 5-year PFS rate was 70.6% and 39.2%, respectively (log-rank p-value = .004).

Conclusions

Our data revealed a significant PFS increase for those treated with adjuvant radiotherapy following surgery compared to surgery alone. Future prospective studies evaluating differing radiation modalities and dosages should be conducted.

中文翻译：

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非典型脑膜瘤的辅助放疗与无进展生存期的改善有关

目的

评估在高级别脑膜瘤患者中，与单独手术相比，手术切除后辅助放疗 (ART) 的无进展生存获益。

方法

我们回顾性地确定了 43 名非典型脑膜瘤患者，他们在 2007 年 2 月至 2019 年 3 月期间在我们的机构接受了放疗术后切除 (Surgery+ART) 或单独手术（Surgery only）。 28 名患者实现了 GTR，在11. 从记录中提取患者、脑膜瘤和治疗数据，并使用 Kaplan-Meier 方法、对数秩检验和 Cox 比例风险模型进行比较。还评估了放射并发症。

结果

总共有 32.6% ( n  = 14) 的患者，即手术+ART 组 6 名患者和单独手术组 8 名患者出现复发。在手术+ART 组中，中位 PFS 时间为 46.5 个月（CI：[35.8-50.6]），而单独手术组为 24.5 个月（CI：[18.3-32.9]）。手术+ART 的 2 年 PFS 为 100%，而单独手术为 69.0%，5 年 PFS 率分别为 70.6% 和 39.2%（对数秩p值 = .004）。

结论

我们的数据显示，与单独手术相比，手术后接受辅助放疗的患者 PFS 显着增加。未来应该进行评估不同辐射方式和剂量的前瞻性研究。