Abstract
Background: For atypical meningiomas (AMs), the combination of gross total resection (GTR) and adjuvant radiotherapy (ART) is still a controversial therapeutic strategy to improve prognosis. This study analyzed the factors influencing the prognosis on AM patients treated with GTR + ART by investigating both clinical characteristics and the change in microRNA (miRNA) expression.Materials and Methods: Adult AM patients who were admitted to the Tiantan hospital from 2008 to 2015 and underwent GTR + ART were included. Patients who suffered recurrence within 3 years after operation were considered radioresistant, while the others were considered radiosensitive. Clinical characterizations were compared between these two groups. The microRNA (miRNA) expression was detected via miRNA microarray in 10 patients, five from the radiosensitive group and from the radioresistant group.Results: A total of 55 cases were included in this study. No significant difference was found in the clinical characteristics (gender, age, tumor location, tumor size, peritumoral brain edema, and Ki-67 index) between radiosensitive and radioresistant patients. We found seven significantly upregulated miRNAs (miR-4286, miR-4695-5p, miR-6732-5p, miR-6855-5p, miR-7977, miR-6765-3p, miR-6787-5p) and seven significantly downregulated miRNAs (miR-1275, miR-30c-1-3p, miR-4449, miR-4539, miR-4684-3p, miR-6129, miR-6891-5p) in patients resistant to radiotherapy. The differentially expressed miRNAs were enriched mostly in the fatty acid metabolic pathways (hsa00061, hsa01212) and transforming growth factor beta signaling pathway (hsa04350).Conclusion: For AM patients treated with GTR + ART, the changes in miRNA expression discovered in this study may be a potential predictor of individual sensitivity to adjuvant radiotherapy. Further research is needed regarding the predictive power and mechanism by which these miRNAs influence prognosis.
Highlights
Meningioma, which has an incidence of 6–7 in 100,000 people, has become the most common primary brain tumor, accounting for 36.3% of all primary central nervous system tumors [1]
Fifty-five cases of atypical meningioma (AM) were included in this study
A total of 43 patients fulfilled the criteria for the radiosensitive group, and 12 patients were included in the radioresistant group
Summary
Meningioma, which has an incidence of 6–7 in 100,000 people, has become the most common primary brain tumor, accounting for 36.3% of all primary central nervous system tumors [1]. Due to the controversial results obtained between different studies, whether the ART is beneficial for the treatment of atypical meningioma (AM) patients, especially for those who underwent gross total resection (GTR, Simpson I–II), remains unclear [4,5,6,7,8,9,10,11]. The only completed prospective study regarding ART after GTR in AM is European Organization for Research and Treatment of Cancer (EORTC) 22042-26042, which showed that the 3-year progression-free survival (PFS) for AM patients undergoing complete resection (Simpson I– III) followed by treatment with high-dose (60 Gy) radiotherapy is over 70% [12]. For atypical meningiomas (AMs), the combination of gross total resection (GTR) and adjuvant radiotherapy (ART) is still a controversial therapeutic strategy to improve prognosis. This study analyzed the factors influencing the prognosis on AM patients treated with GTR + ART by investigating both clinical characteristics and the change in microRNA (miRNA) expression
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