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  • [J Neurooncol .] Dose-response relationship in patients with newly diagnosed atypical meningioma treated with adjuvant radiotherapy

    서울대병원, 연세의대, 서울특별시보라매병원 / 김도욱, 이주호*, 윤홍인*, 위찬우*

  • 출처
    J Neurooncol .
  • 등재일
    2023 Jan
  • 저널이슈번호
    161(2):329-337. doi: 10.1007/s11060-022-04206-1. Epub 2022 Dec 5.
  • 내용

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    Abstract
    Purpose: This study aimed to identify the radiation dose-response relationship in patients with newly diagnosed atypical meningioma (AM) treated with adjuvant radiotherapy (ART) using conventional fractionation.

    Methods: In total, 158 patients who underwent surgery and ART between 1998 and 2018 were reviewed. Among these patients, 135 with complete information on radiotherapy (RT) dose/fractionation and pathological reports were analyzed. We entered RT dose as a continuous variable into the Cox regression model using penalized spline to allow for a nonlinear relationship between RT dose and events. Local control (LC), progression-free survival (PFS), and overall survival (OS) were evaluated. The corresponding biological equivalent dose in 2 Gy fractions (EQD2) was calculated using an α/β ratio of 4 Gy.

    Results: The median follow-up duration was 56.0 months. The median ART dose delivered was 61.2 Gy in 24-34 daily fractions, corresponding to a median EQD2 of 59.16 Gy. In multivariate analysis, larger size and higher mitotic count were associated with significantly reduced LC (P < 0.001 and P = 0.002, respectively), PFS (P < 0.001 and P = 0.006, respectively), and OS (P = 0.006 and P = 0.001, respectively). Meanwhile, a higher RT dose was significantly associated with improved LC, PFS, and OS. Moreover, RT showed a dose-dependent effect on LC, PFS, and OS; local failure, tumor progression, and death were reduced by 12%, 12%, and 16%, respectively, per 1 Gy increase in the dose (EQD2).

    Conclusion: The dose of ART in AM has a dose-response relationship with LC and survival outcomes.

     

     

    Affiliations

    Dowook Kim 1 2, Won Ick Chang 1, Hwa Kyung Byun 3, In Ah Kim 1 4, Jaeho Cho 3, Joo Ho Lee 5, Hong In Yoon 6, Chan Woo Wee 7 8
    1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
    2Department of Radiation Oncology, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
    3Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
    4Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
    5Department of Radiation Oncology, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea. jooho.lee119@gmail.com.
    6Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea. yhi0225@yuhs.ac.
    7Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. wcw0108@hanmail.net.
    8Department of Radiation Oncology, SMG-SNU Boramae Medical Center, 20, Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, Republic of Korea. wcw0108@hanmail.net.

  • 키워드
    Adjuvant therapy; Dose–response relationship; Meningioma; Radiotherapy.
  • 편집위원

    atypical meningioma의 수술 후 방사선치료 결과를 4개 병원의 자료를 이용하여 분석하였을 때, EQD2 57.42 Gy를 기준으로 high-dose RT를 받은 군에서 국소제어율, 무병생존율 및 전체생존율이 모두 양호한 결과를 보임.

    2023-04-04 17:04:40

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