Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study

Background and PurposeConsensus regarding the need for adjuvant radiotherapy (RT) in patients with atypical meningiomas (AMs) is lacking. We compared the effects of adjuvant RT after surgery, gross total resection (GTR), and subtotal resection (STR) on progression-free survival (PFS) and overall sur...

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Autores principales:	Dengpan Song, Dingkang Xu, Hongjie Han, Qiang Gao, Mingchu Zhang, Fang Wang, Guoqing Wang, Fuyou Guo
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	atypical meningioma adjuvant radiotherapy meta-analysis gross total resection subtotal resection progression-free survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/937bf8df19534e96bb589d6f84e3c122
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spelling	oai:doaj.org-article:937bf8df19534e96bb589d6f84e3c1222021-12-02T07:51:11ZPostoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study2234-943X10.3389/fonc.2021.787962https://doaj.org/article/937bf8df19534e96bb589d6f84e3c1222021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.787962/fullhttps://doaj.org/toc/2234-943XBackground and PurposeConsensus regarding the need for adjuvant radiotherapy (RT) in patients with atypical meningiomas (AMs) is lacking. We compared the effects of adjuvant RT after surgery, gross total resection (GTR), and subtotal resection (STR) on progression-free survival (PFS) and overall survival (OS) in patients with AMs, respectively.MethodsWe performed a systematic review and meta-analysis of the literature published in PubMed, Embase, and the Cochrane Library from inception to February 1, 2021, to identify articles comparing the PFS and OS of patients receiving postoperative RT after surgery, GTR and STR.ResultsWe identified 2307 unique studies; 24 articles including 3078 patients met the inclusion criteria. The sensitivity analysis results showed that for patients undergoing undifferentiated surgical resection, adjuvant RT reduced tumor recurrence (HR=0.70, p<0.0001) with no significant effect on survival (HR=0.89, p=0.49). Postoperative RT significantly increased PFS (HR=0.69, p=0.01) and OS (HR=0.55, p=0.007) in patients undergoing GTR. The same improvement was observed in patients undergoing STR plus RT (PFS: HR=0.41, p<0.00001; OS: HR=0.47, p=0.01). A subgroup analysis of RT in patients undergoing GTR showed no change in PFS in patients undergoing Simpson grade I and II resection (HR=1.82, p=0.22) but significant improvement in patients undergoing Simpson grade III resection (HR=0.64, p=0.02).ConclusionRegardless of whether GTR or STR was performed, postoperative RT improved PFS and OS to varying degrees. Especially for patients undergoing Simpson grade III or IV resection, postoperative RT confers the benefits for recurrence and survival.Dengpan SongDingkang XuHongjie HanQiang GaoMingchu ZhangFang WangGuoqing WangFuyou GuoFrontiers Media S.A.articleatypical meningiomaadjuvant radiotherapymeta-analysisgross total resectionsubtotal resectionprogression-free survivalNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atypical meningioma adjuvant radiotherapy meta-analysis gross total resection subtotal resection progression-free survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	atypical meningioma adjuvant radiotherapy meta-analysis gross total resection subtotal resection progression-free survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Dengpan Song Dingkang Xu Hongjie Han Qiang Gao Mingchu Zhang Fang Wang Guoqing Wang Fuyou Guo Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study
description	Background and PurposeConsensus regarding the need for adjuvant radiotherapy (RT) in patients with atypical meningiomas (AMs) is lacking. We compared the effects of adjuvant RT after surgery, gross total resection (GTR), and subtotal resection (STR) on progression-free survival (PFS) and overall survival (OS) in patients with AMs, respectively.MethodsWe performed a systematic review and meta-analysis of the literature published in PubMed, Embase, and the Cochrane Library from inception to February 1, 2021, to identify articles comparing the PFS and OS of patients receiving postoperative RT after surgery, GTR and STR.ResultsWe identified 2307 unique studies; 24 articles including 3078 patients met the inclusion criteria. The sensitivity analysis results showed that for patients undergoing undifferentiated surgical resection, adjuvant RT reduced tumor recurrence (HR=0.70, p<0.0001) with no significant effect on survival (HR=0.89, p=0.49). Postoperative RT significantly increased PFS (HR=0.69, p=0.01) and OS (HR=0.55, p=0.007) in patients undergoing GTR. The same improvement was observed in patients undergoing STR plus RT (PFS: HR=0.41, p<0.00001; OS: HR=0.47, p=0.01). A subgroup analysis of RT in patients undergoing GTR showed no change in PFS in patients undergoing Simpson grade I and II resection (HR=1.82, p=0.22) but significant improvement in patients undergoing Simpson grade III resection (HR=0.64, p=0.02).ConclusionRegardless of whether GTR or STR was performed, postoperative RT improved PFS and OS to varying degrees. Especially for patients undergoing Simpson grade III or IV resection, postoperative RT confers the benefits for recurrence and survival.
format	article
author	Dengpan Song Dingkang Xu Hongjie Han Qiang Gao Mingchu Zhang Fang Wang Guoqing Wang Fuyou Guo
author_facet	Dengpan Song Dingkang Xu Hongjie Han Qiang Gao Mingchu Zhang Fang Wang Guoqing Wang Fuyou Guo
author_sort	Dengpan Song
title	Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study
title_short	Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study
title_full	Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study
title_fullStr	Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study
title_full_unstemmed	Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study
title_sort	postoperative adjuvant radiotherapy in atypical meningioma patients: a meta-analysis study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/937bf8df19534e96bb589d6f84e3c122
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Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients: A Meta-Analysis Study

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