Atypical and Malignant Meningioma: Outcome and Prognostic Factors in 119 Irradiated Patients. A Multicenter, Retrospective Study of the Rare Cancer Network
- Department of Radiation Oncology, Centre O. Lambret and University Lille II, Lille (France)
- Department of Radiation Oncology, Dr. Bernard Verbeeten Instituut, Tilburg (Netherlands)
- Department of Radiation Oncology, H.U. Germans Trias, ICO-Badalona, Barcelona (Spain)
- Department of Radiotherapy, University of Piemonte Orientale, Hospital Maggiore della Carita, Novara (Italy)
- Department of Radiation Oncology, University Hospital, Geneva (Switzerland)
- Department of Radiation Oncology (MAASTRO), GROW, University Hospital Maastricht (Netherlands)
- Department of Radiation Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon (Turkey)
- Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir (Turkey)
- Department of Radiation Oncology, Medical University of Gdansk, Gdansk (Poland)
- Northern Israel Oncology Centre, Rambam Medical Centre, Haifa (Israel)
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)
Purpose: To retrospectively analyze and assess the outcomes and prognostic factors in a large number of patients with atypical and malignant meningiomas. Methods and Materials: Ten academic medical centers participating in this Rare Cancer Network contributed 119 cases of patients with atypical or malignant meningiomas treated with external beam radiotherapy (EBRT) after surgery or for recurrence. Eligibility criteria were histologically proven atypical or anaplastic (malignant) meningioma (World Health Organization Grade 2 and 3) treated with fractionated EBRT after initial resection or for recurrence, and age >18 years. Sex ratio (male/female) was 1.3, and mean ({+-}SD) age was 57.6 {+-} 12 years. Surgery was macroscopically complete (Simpson Grades 1-3) in 71% of patients; histology was atypical and malignant in 69% and 31%, respectively. Mean dose of EBRT was 54.6 {+-} 5.1 Gy (range, 40-66 Gy). Median follow-up was 4.1 years. Results: The 5- and 10-year actuarial overall survival rates were 65% and 51%, respectively, and were significantly influenced by age >60 years (p = 0.005), Karnofsky performance status (KPS) (p = 0.01), and high mitotic rate (p = 0.047) on univariate analysis. On multivariate analysis age >60 years (p = 0.001) and high mitotic rate (p = 0.02) remained significant adverse prognostic factors. The 5- and 10-year disease-free survival rates were 58% and 48%, respectively, and were significantly influenced by KPS (p 0.04) and high mitotic rate (p = 0.003) on univariate analysis. On multivariate analysis only high mitotic rate (p = 0.003) remained a significant prognostic factor. Conclusions: In this multicenter retrospective study, age, KPS, and mitotic rate influenced outcome. Multicenter prospective studies are necessary to clarify the management and prognostic factors of such a rare disease.
- OSTI ID:
- 21124393
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 71, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2007.12.020; PII: S0360-3016(07)04760-8; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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