Should adjuvant radiotherapy be used in atypical meningioma (WHO grade 2) following gross total resection? A systematic review and Meta-analysis.
Atypical meningioma
WHO grade 2 meningioma
adjuvant
gross total resection
radiotherapy
Journal
Acta oncologica (Stockholm, Sweden)
ISSN: 1651-226X
Titre abrégé: Acta Oncol
Pays: England
ID NLM: 8709065
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
pubmed:
3
9
2022
medline:
16
11
2022
entrez:
2
9
2022
Statut:
ppublish
Résumé
The role of adjuvant radiotherapy (RT) following gross total resection (GTR) in atypical meningioma (AM) is not well established and its benefit remains unclear. We aim to evaluate the survival benefit of adjuvant RT in AM following GTR. We searched biomedical databases for studies published between January 1964-February 2021 and included studies reporting primary outcomes of 5-year PFS, 5-year OS and had survival curves for restricted mean survival time (RMST) calculations. Data extracted from survival curves were pooled and analyzed using a random-effects model. Hazard ratio (HR) was calculated for sensitivity analysis. We included 12 non-randomized studies comprising 1,078 patients. 803 (74.5%) patients were treated with GTR alone and 275 (25.5%) patients received adjuvant RT. In 9 studies, RT included 3 D conformal RT, intensity modulated RT, or fractionated stereotactic radiotherapy); in 3 studies, stereotactic radiosurgery was also used. Median dose of RT was 59.4 Gy. Adjuvant RT resulted in an increase of 3.9 months for restricted mean PFS truncated at 5 years (95% CI 0.23-7.72; Adjuvant RT following GTR in patients with AM improved restricted mean PFS and OS. While we await the results from ongoing randomized controlled trials, adjuvant RT should be recommended.
Sections du résumé
BACKGROUND
UNASSIGNED
The role of adjuvant radiotherapy (RT) following gross total resection (GTR) in atypical meningioma (AM) is not well established and its benefit remains unclear. We aim to evaluate the survival benefit of adjuvant RT in AM following GTR.
METHODS
UNASSIGNED
We searched biomedical databases for studies published between January 1964-February 2021 and included studies reporting primary outcomes of 5-year PFS, 5-year OS and had survival curves for restricted mean survival time (RMST) calculations. Data extracted from survival curves were pooled and analyzed using a random-effects model. Hazard ratio (HR) was calculated for sensitivity analysis.
RESULTS
UNASSIGNED
We included 12 non-randomized studies comprising 1,078 patients. 803 (74.5%) patients were treated with GTR alone and 275 (25.5%) patients received adjuvant RT. In 9 studies, RT included 3 D conformal RT, intensity modulated RT, or fractionated stereotactic radiotherapy); in 3 studies, stereotactic radiosurgery was also used. Median dose of RT was 59.4 Gy. Adjuvant RT resulted in an increase of 3.9 months for restricted mean PFS truncated at 5 years (95% CI 0.23-7.72;
CONCLUSION
UNASSIGNED
Adjuvant RT following GTR in patients with AM improved restricted mean PFS and OS. While we await the results from ongoing randomized controlled trials, adjuvant RT should be recommended.
Identifiants
pubmed: 36052871
doi: 10.1080/0284186X.2022.2116994
doi:
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM