Integrative assessment of brain and bone invasion in meningioma patients.
Adult
Aged
Aged, 80 and over
Bone Neoplasms
/ diagnostic imaging
Brain Neoplasms
/ diagnostic imaging
Female
Humans
Male
Meningeal Neoplasms
/ pathology
Meningioma
/ radiotherapy
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
/ diagnostic imaging
Prognosis
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
/ methods
Radiotherapy, Intensity-Modulated
/ adverse effects
Retrospective Studies
Salvage Therapy
Survival Rate
Young Adult
Bone involvement
Brain invasion
Meningioma
Prognostic factors
Radiotherapy
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
29 Jul 2019
29 Jul 2019
Historique:
received:
28
03
2019
accepted:
18
07
2019
entrez:
31
7
2019
pubmed:
31
7
2019
medline:
10
1
2020
Statut:
epublish
Résumé
Various prognostic factors have been suggested in meningioma patients including WHO grading, brain invasion and bone involvement, for instance. Brain invasion was included as an independent criterion in the recent WHO classification. However, assessability of brain or bone involvement is often limited or varies between histopathologic, operative and imaging reports. Objective of our study was to investigate prognostic values including brain and bone involvement according to different clinical approaches. A cohort of 111 patients was treated with primary, adjuvant or salvage irradiation between 2008 and 2017 using intensity-modulated radiotherapy. Positron-emission tomography (PET) was available for treatment planning in 81% of patients. Clinical data were extracted from the medical reports. Brain and bone involvement were stratified separately according to histopathologic, operative and imaging reports as well as judged in synopsis. WHO grade I tumours, lower estimated proliferation index, primary versus recurrence treatment and localization (i.e. skull base, optic nerve sheath) were beneficial prognostic factors for local control. Judgement of brain and bone invasion partly differed between diagnostic modalities. In synopsis, brain or bone invasion did not show a significant influence on local control rates. Several previously described prognostic factors could be reproduced. However, partly divergent histopathological, surgical and image-based judgements could be found in regard to brain and bone invasion and all methods imply limitations. Therefore, we suggest a particular, complemental synopsis judgement. In synopsis, brain or bone involvement did not coherently impair local control in our irradiated patients. This might be explained by elaborate radiation techniques and PET-based treatment planning.
Sections du résumé
BACKGROUND
BACKGROUND
Various prognostic factors have been suggested in meningioma patients including WHO grading, brain invasion and bone involvement, for instance. Brain invasion was included as an independent criterion in the recent WHO classification. However, assessability of brain or bone involvement is often limited or varies between histopathologic, operative and imaging reports. Objective of our study was to investigate prognostic values including brain and bone involvement according to different clinical approaches.
METHODS
METHODS
A cohort of 111 patients was treated with primary, adjuvant or salvage irradiation between 2008 and 2017 using intensity-modulated radiotherapy. Positron-emission tomography (PET) was available for treatment planning in 81% of patients. Clinical data were extracted from the medical reports. Brain and bone involvement were stratified separately according to histopathologic, operative and imaging reports as well as judged in synopsis.
RESULTS
RESULTS
WHO grade I tumours, lower estimated proliferation index, primary versus recurrence treatment and localization (i.e. skull base, optic nerve sheath) were beneficial prognostic factors for local control. Judgement of brain and bone invasion partly differed between diagnostic modalities. In synopsis, brain or bone invasion did not show a significant influence on local control rates.
CONCLUSIONS
CONCLUSIONS
Several previously described prognostic factors could be reproduced. However, partly divergent histopathological, surgical and image-based judgements could be found in regard to brain and bone invasion and all methods imply limitations. Therefore, we suggest a particular, complemental synopsis judgement. In synopsis, brain or bone involvement did not coherently impair local control in our irradiated patients. This might be explained by elaborate radiation techniques and PET-based treatment planning.
Identifiants
pubmed: 31358024
doi: 10.1186/s13014-019-1341-x
pii: 10.1186/s13014-019-1341-x
pmc: PMC6664715
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
132Subventions
Organisme : Fortüne / PATE Program of the Medical Faculty, Eberhard Karls University of Tuebingen
ID : 2447-0-0
Organisme : Else Kröner-Fresenius-Stiftung, Bad Homburg, Germany
ID : 2015_Kolleg.14
Organisme : Deutsche Forschungsgemeinschaft and the Open Access Publishing Fund of the University of Tuebingen
ID : not applicable
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