Effectiveness of Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients After Gross Total Resection: A Meta-Analysis Study.

Lingzhe He,Jianmin Zhang,Zhige Guo,Qiang Zeng,Buyi Zhang,Feina Shi

doi:10.3389/fonc.2020.556575

Abstract

BackgroundIt still remains unclear whether patients with atypical meningioma (AM) could benefit from postoperative adjuvant radiotherapy (PORT) after gross-total resection (GTR).ObjectiveExploring the effectiveness of PORT on AM patients after GTR.MethodsLiteratures on PubMed, Embase, Web of science, and Scopus databases published between January 2000 and January 2019 were searched. After the selection based on the certain exclusion criteria, the Newcastle-Ottawa evaluation scale was used to evaluate the quality of the included literatures. Finally, a meta-analysis was conducted to analyze the effectiveness of PORT on local control (LC), progression-free survival (PFS) and overall survival (OS) in atypical meningioma patients after GTR.ResultsA total of 17 articles with 2,008 AM patients were included in the meta-analysis. The 5-year LC, 5-year PFS, and 5-year OS rates were 82.2, 84.1, and 79.0%, respectively, for AM patients receiving PORT after GTR, and they were 71.0, 71.9, and 81.5%, respectively, for those not receiving PORT after GTR. PORT could significantly improve 5-year LC rate (OR [95% Cl] = 2.59 [1.40–4.81], P = 0.002) and 5-year PFS rate (OR [95% Cl] = 1.99 [1.35–2.95], P = 0.001), but did not significantly improve 5-year OS rate (OR [95% Cl] = 1.07 [0.60–1.91], P = 0.828).ConclusionPORT could improve the 5-year LC rate and 5-year PFS rate in AM patients after GTR. AM patients might benefit from PORT after GTR.

Highlights

Meningiomas are the most common primary intracranial tumors with an incidence rate of about 8 per 100,000 population, accounting for approximately 37% of all central nervous system tumors [1]
postoperative adjuvant radiotherapy (PORT) could significantly improve 5-year local control (LC) rate (OR [95% Cl] = 2.59 [1.40–4.81], P = 0.002) and 5-year progression-free survival (PFS) rate (OR [95% Cl] = 1.99 [1.35–2.95], P = 0.001), but did not significantly improve 5-year overall survival (OS) rate (OR [95% Cl] = 1.07 [0.60–1.91], P = 0.828)
atypical meningioma (AM) patients might benefit from PORT after gross-total resection (GTR)

Summary

Introduction

Meningiomas are the most common primary intracranial tumors with an incidence rate of about 8 per 100,000 population, accounting for approximately 37% of all central nervous system tumors [1]. The common consensus is that postoperative adjuvant radiotherapy (PORT) is generally recommended for meningioma patients underwent subtotal resection (STR). After GTR, follow-up observation is generally recommended for benign meningioma patients, while adjuvant radiotherapy is routinely recommended for malignant meningioma patients (WHO grade III) [6]. Whereas our recent study based on the Surveillance, Epidemiology, and End Results database found that PORT might not prolong the overall survival (OS) in AM patients undergoing GTR [27]. It still remains unclear whether patients with atypical meningioma (AM) could benefit from postoperative adjuvant radiotherapy (PORT) after gross-total resection (GTR)

Methods

Results

Conclusion