Management Approaches in WHO Grade III Meningioma: A National Oncology Trainees' Collaborative for Healthcare Research (NOTCH) UK Multi-Centre Retrospective Study.

Autor: Dobeson CB; Northern Centre for Cancer Care, Freeman Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, England, NE77DN, UK. Electronic address: c.dobeson@nhs.net., Baxter M; Tayside Cancer Centre, Ninewells Hospital, Dundee, NHS Tayside, Scotland, DD1 9SY, UK., Rowe M; Sunrise Oncology Centre, Royal Cornwall Hospitals NHS Trust, Truro, England, TR1 3LJ, UK., Kingdon S; Plymouth Oncology Centre, University Hospitals Plymouth NHS Trust, England, PL6 8DH, UK., Park S; Plymouth Oncology Centre, University Hospitals Plymouth NHS Trust, England, PL6 8DH, UK., Bond H; Plymouth Oncology Centre, University Hospitals Plymouth NHS Trust, England, PL6 8DH, UK., Taylor K; The Northern Ireland Cancer Centre, Belfast, Northern Ireland, BT12 6BA, UK., Islim AI; The Christie NHS Foundation Trust, Manchester, England, M20 4BX, UK., King J; The Christie NHS Foundation Trust, Manchester, England, M20 4BX, UK., Millward CP; The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK., Zakaria R; The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK., Clynch AL; The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK., Keshwara SM; The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK., Eltinay A; Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, England, OX3 7LE, UK., Kviat L; The Royal Marsden Hospital NHS Foundation Trust, London, England, SW3 6JJ, UK., Robinson R; The Royal Marsden Hospital NHS Foundation Trust, London, England, SW3 6JJ, UK., Haris PA; University Hospitals of Leicester NHS Trust, England, LE3 9QP, UK., Samuel R; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, England, LS9 7TF, UK., Venkatesh V; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, England, LS9 7TF, UK., Derby S; The Beatson West of Scotland Cancer Centre, Glasgow, Scotland, G12 0YN, UK., Ahmad S; University Hospitals of Leicester NHS Trust, England, LE3 9QP, UK., Smith F; Nottingham University Hospitals NHS Trust, England, NG7 2UH, UK., Robinson S; Imperial College Healthcare NHS Trust, London, England, W2 1NY, UK., Kathirgamakarthigeyan S; Nottingham University Hospitals NHS Trust, England, NG7 2UH, UK., Narramneni LR; Aberdeen Royal Infirmary, NHS Grampian, Scotland, AB25 2ZN, UK., Hannan CJ; The Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK., Lewis J; Northern Centre for Cancer Care, Freeman Hospital, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, England, NE77DN, UK.
Jazyk: angličtina
Zdroj: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2024 Sep; Vol. 36 (9), pp. e301-e311. Date of Electronic Publication: 2024 May 13.
DOI: 10.1016/j.clon.2024.05.006
Abstrakt: Aims: WHO Grade 3 (G3) meningiomas are rare tumours with limited data to guide management. This retrospective study documents UK management approaches across 14 centres over 11 years.
Materials and Methods: Patients with WHO G3 meningioma between 01/01/2008 and 31/12/2018 were identified. Data were collected on demographics, management strategy, adjuvant radiotherapy, approach in recurrence setting and survival.
Results: 84 patients were identified. 21.4% transformed from lower-grade disease. 96.4% underwent primary surgical resection, with 20.8% having evidence of residual disease on their post-op MRI. 59.3% of patients underwent adjuvant radiotherapy (RT) following surgical resection. Overall median PFS and OS were 12.6 months and 28.2 months, respectively. Median OS in the group who underwent complete surgical resection was 34.9 months, compared to 27.5 months for those who had incomplete resection (HR 0.58, 95% CI 0.27-1.23, p = 0.15). Median OS was 33.1 months for those who underwent adjuvant RT and 14.0 months for those who did not (HR 0.48, 95% CI 0.27-0.84, p = 0.004). Median adjuvant RT dose delivered was 60Gy (range 12Gy-60Gy), 45.8% of adjuvant RT was delivered using IMRT. At disease relapse, 31% underwent salvage surgery and 29.3% underwent salvage RT. Of those treated with salvage RT, 64.7% were re-treats and all were treated with hypofractionated RT.
Conclusion: Surgery continues to be the preferred primary management strategy. Post-operative MRI within 48 hours is indicated to assess presence of residual disease and guide further surgical options. Adjuvant radiotherapy plays an important part of the management paradigm in these patients with the data supporting an attached survival advantage. Further surgery and re-irradiation is an option in the disease recurrence setting with radiosurgery frequently utilised in this context.
(Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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