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01-09-2019 | Meningioma | Clinical Study

Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma

Authors: Jason Joon Bock Lee, Jeongshim Lee, Hong In Yoon, Se Hoon Kim, Jaeho Cho, Kyu Sung Lee, Jong Hee Chang, Chang-Ok Suh

Published in: Journal of Neuro-Oncology | Issue 2/2019

Abstract

Purpose

To analyze patterns of failure according to treatment modalities and evaluate the adequacy of an institution’s current volume of postoperative radiotherapy (PORT) for World Health Organization (WHO) grade II or III meningiomas.

Patients and methods

Data of 98 patients treated by either surgery and PORT (PORT group, n = 53) or surgery alone (surgery group, n = 45) between March 2000 and December 2013 were reviewed. Clinical target volume of PORT was delineated as a 1.5–2-cm expansion from the tumor bed. Local failure (LF) was defined as recurrence within a 2-cm margin from the tumor bed. Failures other than LF were defined as out-field failure (OFF). Median total dose of PORT was 59.4 (range 45.0–69.0) Gy.

Results

The PORT group had larger proportions of grade III meningiomas (18/53, 34.0%) than the surgery group (8/46, 15.6%) (p = 0.037). After a median 73.4-month follow-up, 29 patients experienced LF and 5 developed OFF. The actuarial 5-year local control (LC) rates were 86.7% and 59.3% in the PORT and surgery groups, respectively (p = 0.002). PORT was a significant factor of LC in the univariate (p = 0.003, hazard ratio [HR] 3.449, 95% confidence interval [CI] 1.516–7.846) and multivariate analyses (p < 0.001, HR 5.486, 95% CI 2.178–13.820).

Conclusions

Despite the larger proportion of grade III meningiomas in the PORT group, PORT reduced LF in patients with WHO grade II or III meningiomas compared with the surgery group. The current PORT field seems reasonable because LF was the dominant pattern of failure in patients treated by surgery alone.

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Title: Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma
Authors: Jason Joon Bock Lee
Jeongshim Lee
Hong In Yoon
Se Hoon Kim
Jaeho Cho
Kyu Sung Lee
Jong Hee Chang
Chang-Ok Suh
Publication date: 01-09-2019
Publisher: Springer US
Keywords: Meningioma
Meningioma
Radiotherapy
Published in: Journal of Neuro-Oncology / Issue 2/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03232-w

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma

Abstract

Purpose

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusions

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