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자료유형
학술저널
저자정보
Champeaux-Depond Charles (Department of Neurosurgery Lariboisière Hospital Paris France) Weller Joconde (Agence régionale de santé Saint Denis France.)
저널정보
대한뇌종양학회 Brain Tumor Research and Treatment Brain Tumor Research and Treatment Vol.9 No.2
발행연도
2021.10
수록면
46 - 57 (12page)
DOI
10.14791/btrt.2021.9.e9

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Background To assess the outcome after meningioma surgery and protontherapy (PT). Methods We processed the French Systeme National des Donnees de Sante database to retrieve appropriate cases of meningiomas operated and irradiated between 2008 and 2017. Survival methods were implemented. Results One hundred ninety-three patients who received PT after meningioma surgery over a 10-year period were identified. Of the 193 patients, 75.6% were female. Median age at surgery was 50 years (interquartile range [IQR] 41-62). The median number of PT fractions was 31 (IQR 30-39) given over a median duration of 52 days (IQR 44-69). Fourteen patients (7.3%) also received photon radiotherapy and six patients (3.1%) stereotactic radiosurgery. Median follow-up was 4.4 years (IQR 3.86- 4.71). Five-year progression-free survival (PFS) rate was 69% (95% confidence interval [CI] 62.1?76.6). For benign, atypical, and malignant meningioma, 5-year PFS rates were 71.5% (95% CI 64.4-79.4), 55.6% (95% CI 32.5-95), and 35.6% (95% CI 12.8-98.9), respectively (p<0.01). In the adjusted regression, tumour location (hazard ratio [HR]=0.1, 95% CI 0.05-0.22, p<0.001), aggressive meningioma (HR=2.26, 95% CI 1.1-4.66, p=0.027), and the need of cerebrospinal fluid (CSF) insertion for hydrocephalus (HR=3.51, 95% CI 1.32-9.31, p=0.012) remained significantly associated to the PFS. All grades considered, 5-year overall survival (OS) rates was 89.7% (95% CI 84.6-95.1). For benign, atypical, and malignant meningioma, 5-year OS rates were 93% (95% CI 88.7-97.4), 76.4% (95% CI 51.4-100), and 44.4% (95% CI 16.7-100), respectively (p<0.01). In the multivariable regression, an older age above 70 years (HR=5.95, 95% CI 2.09-16.89, p<0.001) associated to a high level of comorbidities (HR=5.31, 95% CI 1.43-19.78, p=0.013) and a malignant meningioma (HR=5.68, 95% CI 1.54-20.94, p=0.009) remained significantly associated to a reduced OS. Conclusion Five-year PFS and OS after meningioma surgery and PT is favourable but impaired for older patients with high level of morbidities, tumour of the convexity, malignant histopathology and for those requiring CSF shunting. Further inclusion and prolonged follow-up is required to assess other predictors such as sex, tumour volume, or given dose.
#Meningioma #Proton therapy #Radiotherapy #Survival #Progression-free survival #Systeme National des Donnees de Sante.

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참고문헌 (35)

참고문헌 신청
Champeaux C / 2015 / World Health Organization grade III meningiomas. A retrospective study for outcome and prognostic factors assessment / Br J Neurosurg 29:693~698 google schola Champeaux C / 2016 / World Health Organization grade II meningioma : a 10-year retrospective study for recurrence and prognostic factor assessment / World Neurosurg 89:180~186 google schola Champeaux C / 2017 / Atypical meningioma. A study on recurrence and disease-specific survival / Neurochirurgie 63:273~281 google schola Gavrielov-Yusim N / 2014 / Use of administrative medical databases in population-based research / J Epidemiol Community Health 68:283~287 google schola Tuppin P / 2017 / Value of a national administrative database to guide public decisions : from the système national d’information interrégimes de l’Assurance Maladie(SNIIRAM)to the système national des données de santé(SNDS)in France / Rev Epidemiol Sante Publique google schola

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