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Long-Term Outcomes for Patients With Atypical or Malignant Meningiomas Treated With or Without Radiation Therapy: A 25-Year Retrospective Analysis of a Single-Institution Experience.

Publication ,  Journal Article
Kent, CL; Mowery, YM; Babatunde, O; Wright, AO; Barak, I; McSherry, F; Herndon, JE; Friedman, AH; Zomorodi, A; Peters, K; Desjardins, A ...
Published in: Adv Radiat Oncol
2022

PURPOSE: Atypical (World Health Organization [WHO] grade 2) and malignant (WHO grade 3) meningiomas have high rates of local recurrence, and questions remain about the role of adjuvant radiation therapy (RT) for patients with WHO grade 2 disease. These patients frequently require salvage therapy, and optimal management is uncertain given limited prospective data. We report on the long-term outcomes for patients with atypical and malignant meningiomas treated with surgery and/or RT at our institution. METHODS AND MATERIALS: Data were collected through a retrospective chart review for all patients with WHO grade 2 or 3 meningiomas treated with surgery and/or RT at our institution between January 1992 and March 2017. Progression-free survival (PFS) and overall survival (OS) were described using the KaplanMeier estimator. The outcomes in the subgroups were compared with a log-rank test. A Cox proportional hazards model was used for the univariable and multivariable analyses of predictors of PFS. RESULTS: A total of 66 patients were included in this analysis. The median follow-up was 12.4 years overall and 8.6 years among surviving patients. Fifty-two patients (78.8%) had WHO grade 2 meningiomas, and 14 patients (21.2%) had WHO grade 3 disease. Thirty-six patients (54.5%) were treated with surgery alone, 28 patients (42.4%) with surgery and adjuvant RT, and 2 patients (3%) with RT alone. Median PFS and OS were 3.2 years and 8.8 years, respectively. PFS was significantly improved with adjuvant RT compared with surgery alone (hazard ratio, 0.36; 95% confidence interval, 0.18-0.70). Patients with Ki-67 index >10% showed a trend toward worse PFS compared with patients with Ki-67 ≤10% (hazard ratio, 0.51; 95% confidence interval, 0.25-1.04). No significant differences in PFS or OS were observed with respect to Simpson or WHO grade. CONCLUSIONS: For patients with atypical or malignant meningiomas, adjuvant RT was associated with significantly improved PFS, and Ki-67 index >10% was associated with a trend toward worse PFS. Given the long-term survival, high recurrence rates, and efficacy of salvage therapy, patients with atypical and malignant meningiomas should be monitored systematically long after initial treatment.

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Published In

Adv Radiat Oncol

DOI

ISSN

2452-1094

Publication Date

2022

Volume

7

Issue

3

Start / End Page

100878

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kent, C. L., Mowery, Y. M., Babatunde, O., Wright, A. O., Barak, I., McSherry, F., … Kirkpatrick, J. P. (2022). Long-Term Outcomes for Patients With Atypical or Malignant Meningiomas Treated With or Without Radiation Therapy: A 25-Year Retrospective Analysis of a Single-Institution Experience. Adv Radiat Oncol, 7(3), 100878. https://doi.org/10.1016/j.adro.2021.100878
Kent, Collin L., Yvonne M. Mowery, Olayode Babatunde, Ato O. Wright, Ian Barak, Frances McSherry, James E. Herndon, et al. “Long-Term Outcomes for Patients With Atypical or Malignant Meningiomas Treated With or Without Radiation Therapy: A 25-Year Retrospective Analysis of a Single-Institution Experience.Adv Radiat Oncol 7, no. 3 (2022): 100878. https://doi.org/10.1016/j.adro.2021.100878.
Kent CL, Mowery YM, Babatunde O, Wright AO, Barak I, McSherry F, Herndon JE, Friedman AH, Zomorodi A, Peters K, Desjardins A, Friedman H, Sperduto W, Kirkpatrick JP. Long-Term Outcomes for Patients With Atypical or Malignant Meningiomas Treated With or Without Radiation Therapy: A 25-Year Retrospective Analysis of a Single-Institution Experience. Adv Radiat Oncol. 2022;7(3):100878.
Journal cover image

Published In

Adv Radiat Oncol

DOI

ISSN

2452-1094

Publication Date

2022

Volume

7

Issue

3

Start / End Page

100878

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis