Surgery alone versus surgery plus adjuvant radiotherapy for WHO grade 2 meningioma: meta-analysis of reconstructed time-to-event data.
Atypical meningioma
Cancer
Meningioma
Radiation
Radiotherapy
Journal
Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181
Informations de publication
Date de publication:
28 Sep 2024
28 Sep 2024
Historique:
received:
13
03
2024
accepted:
21
09
2024
revised:
20
09
2024
medline:
28
9
2024
pubmed:
28
9
2024
entrez:
27
9
2024
Statut:
epublish
Résumé
WHO Grade 2 meningiomas present diagnostic and management challenges. Surgery, particularly gross total resection (GTR), is crucial, often followed by adjuvant radiotherapy (RT); however, there are clinical equipoise and ongoing randomized trials of RT after GTR. This systematic review evaluates the efficacy of gross total resection (GTR) and GTR plus adjuvant radiotherapy (RT) for WHO grade 2 meningiomas, adhering to PRISMA guidelines. It excludes irrelevant studies, conducts a thorough search until January 2024, and specifically analyzes overall survival (OS) and progression-free survival (PFS) outcomes for WHO grade 2 meningiomas. Statistical analysis adopts a two-stage approach with the R package "IPDfromKM," and quality assessment is conducted using the ROBINS-I tool. In our analysis of 23 studies involving 3822 WHO grade 2 meningioma patients, GTR + RT resulted in a significantly longer PFS (HR: 0.849, 95% CI: 0.730 to 0.988, p = 0.035) compared to GTR alone. Although OS trended better with GTR + RT (HR: 0.79, 95% CI: 0.57 to 1.11, p = 0.173), the difference was not statistically significant, suggesting the need for further investigation. Our study reveals a benefit to adjuvant RT for improving PFS for WHO grade 2 meningiomas. Integrating molecular characteristics into treatment strategies will refine the management of these tumors in the future.
Identifiants
pubmed: 39333271
doi: 10.1007/s10143-024-02946-4
pii: 10.1007/s10143-024-02946-4
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
702Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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