THE ROLE OF RADIOTHERAPY IN THE MANAGEMENT OF INTRACRANIAL MENINGIOMAS - THE ROYAL-MARSDEN-HOSPITAL EXPERIENCE WITH 186 PATIENTS

被引:135
作者
GLAHOLM, J
BLOOM, HJG
CROW, JH
机构
[1] The Royal Marsden Hospital, Department of Radiotherapy and Oncology, Sutton, Surrey SM2 5PT England, Downs Road
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1990年 / 18卷 / 04期
关键词
Meningioma; Radiotherapy;
D O I
10.1016/0360-3016(90)90394-Y
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
One hundred and eighty-six patients with intracranial meningiomas were treated at the Royal Marsden Hospital between 1963 and 1983 with megavoltage photon irradiation (60Co gamma rays and 6-8 Mv. X rays). Survival parameters were measured from the time of referral for radiotherapy. The 10-year actuarial cause-specific survival was 67% for all cases and the actuarial disease-free survival was 61 %. Both malignant and also "aggressive benign" histologies were associated with poor long-term survival. Benign angioblastic meningioma was associated with lower actuarial cause specific and disease-free survival compared with other benign histological sub-groups. Prognosis was related to the extent of initial surgical resection. Of those who underwent subtotal or partial tumor resection with post-operative radiotherapy the 10-year actuarial cause-specific survival was 77%, and in inoperable patients treated by radiotherapy alone it was 46%. Radiotherapy alone resulted in improvement of neurological performance (Karnofsky) in 12 out of the 32 (38%) patients with inoperable disease. The 10-year survival of patients referred for irradiation following "complete" surgical resection was only 34% owing to the high incidence of adverse histological sub-types in this treatment sub-group. Based upon univariate analysis, performance status of less than 60 (Karnofsky) and also age greater than 50 years at the time of referral for radiotherapy were adverse prognostic factors. Multivariate analysis revealed that histological type, extent of surgical resection and performance status at the time of presentation for radiotherapy were independant prognostic variables. However age at the time of referral lost significance as an independant variable when analyzed using this method. Patients undergoing complete surgical resection for the typical benign non-aggressive meningioma do not require adjuvant irradiation. The results of this study support the role of radiotherapy for treatment of incompletely resected and inoperable meningioma of all 3 histological types (benign, "aggressive benign", malignant). © 1990.
引用
收藏
页码:755 / 761
页数:7
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