Scholarlink

Purpose <p>The role of adjuvant fractionated radiotherapy (aFRT) after gross total resection (GTR) of WHO-2 meningiomas remains unclear. We aimed to estimate the effect of aFRT on recurrence risk and survival following GTR and subtotal resection (STR).</p> Methods <p>We analyzed 1452 patients with WHO-2 from our international, multicenter database (followed between 1989 and 2019). Outcomes were recurrence (10-year follow-up) and death (5-year follow-up). Risk estimates were obtained using competing risks and survival analysis. Average treatment effects were estimated by <i>G</i>-computation, adjusted for potential confounding by age, sex, Simpson grade, Ki-67 proliferation index, location, country group (universal healthcare or not), and year of treatment initiation. The robustness of findings was examined through sensitivity analyses.</p> Results <p>Overall, 276 of 1452 patients (19.0%) received aFRT. Among GTR patients, unadjusted analysis showed comparable recurrence proportions between irradiated and non-irradiated patients (25.5% vs. 22.8% within 5 years). Adjusted analyses provided no evidence that aFRT reduced the risk of recurrence (largest difference: −2.7%, 95% CI −5.6 to 0.2); although, the CIs include the possibility of small beneficial effects. In STR patients, aFRT was associated with reduced recurrence risk in both unadjusted and adjusted analyses. Unexpectedly, a higher mortality was observed among irradiated GTR patients, largely driven by older patients with low Ki-67 PI receiving aFRT. Sensitivity analyses showed similar results for patients with STR but discrepancy in estimates for those with GTR.</p> Conclusion <p>Adjuvant FRT showed a consistent reduction in recurrence risk after STR while inconsistent recurrence risk estimates were observed for patients with GTR. The findings reflect efficacy of aFRT using real-world data without standardized guidelines.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Fractionated radiotherapy adjuvant to surgery of WHO-2 meningioma with and without gross total resection: a multicenter, retrospective cohort study of 1,452 patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月9日

查看全文
  • Christian Mirian,
  • Lasse Rehné Jensen,
  • Adam Gorm Hoffmann,
  • Tareq A. Juratli,
  • Andrea Daniela Maier,
  • Pernilla Lindner,
  • Anders Broechner,
  • Sverre H. Torp,
  • Helen A. Shih,
  • Ramin A. Morshed,
  • Jacob S. Young,
  • Stephen T. Magill,
  • Walter Stummer,
  • Dorothee Cäcilia Spille,
  • Benjamin Brokinkel,
  • Martin Proescholdt,
  • Yasuhiro Kuroi,
  • Konstantinos Gousias,
  • Matthias Simon,
  • Ricardo Prat-Acin,
  • Stéphane Goutagny,
  • Johannes Wach,
  • Erdem Güresir,
  • Junkoh Yamamoto,
  • Young Zoon Kim,
  • Joo Ho Lee,
  • Daniel W. Kim,
  • Matthew Koshy,
  • Donald M. Cannon,
  • Dennis C. Shrieve,
  • Chang-Ok Suh,
  • Jong Hee Chang,
  • Maria Kamenova,
  • Sven Straumann,
  • Jehuda Soleman,
  • Ilker Y. Eyüpoglu,
  • Tony Catalan,
  • Austin Lui,
  • Philip V. Theodosopoulos,
  • Michael W. McDermott,
  • Pedro Góes,
  • Fang Wang,
  • Luis Souhami,
  • Marie-Christine Guiot,
  • Tamás Csonka,
  • Toshiki Endo,
  • Tejpal Gupta,
  • Akash J. Patel,
  • Tiemo J. Klisch,
  • Jun Won Kim,
  • Francesco Maiuri,
  • Valeria Barresi,
  • María Dolores Tabernero,
  • Simon Skyrman,
  • Mechthild Krause,
  • Ian Law,
  • Bjarne Winther Kristensen,
  • Tina Nørgaard Munch,
  • Torstein Meling,
  • Kåre Fugleholm,
  • Paul Blanche,
  • Tiit Mathiesen

摘要

Purpose

The role of adjuvant fractionated radiotherapy (aFRT) after gross total resection (GTR) of WHO-2 meningiomas remains unclear. We aimed to estimate the effect of aFRT on recurrence risk and survival following GTR and subtotal resection (STR).

Methods

We analyzed 1452 patients with WHO-2 from our international, multicenter database (followed between 1989 and 2019). Outcomes were recurrence (10-year follow-up) and death (5-year follow-up). Risk estimates were obtained using competing risks and survival analysis. Average treatment effects were estimated by G-computation, adjusted for potential confounding by age, sex, Simpson grade, Ki-67 proliferation index, location, country group (universal healthcare or not), and year of treatment initiation. The robustness of findings was examined through sensitivity analyses.

Results

Overall, 276 of 1452 patients (19.0%) received aFRT. Among GTR patients, unadjusted analysis showed comparable recurrence proportions between irradiated and non-irradiated patients (25.5% vs. 22.8% within 5 years). Adjusted analyses provided no evidence that aFRT reduced the risk of recurrence (largest difference: −2.7%, 95% CI −5.6 to 0.2); although, the CIs include the possibility of small beneficial effects. In STR patients, aFRT was associated with reduced recurrence risk in both unadjusted and adjusted analyses. Unexpectedly, a higher mortality was observed among irradiated GTR patients, largely driven by older patients with low Ki-67 PI receiving aFRT. Sensitivity analyses showed similar results for patients with STR but discrepancy in estimates for those with GTR.

Conclusion

Adjuvant FRT showed a consistent reduction in recurrence risk after STR while inconsistent recurrence risk estimates were observed for patients with GTR. The findings reflect efficacy of aFRT using real-world data without standardized guidelines.