scholarly journals Effectiveness of Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients After Gross Total Resection: A Meta-Analysis Study

2021 ◽  
Vol 10 ◽  
Author(s):  
Lingzhe He ◽  
Buyi Zhang ◽  
Jianmin Zhang ◽  
Zhige Guo ◽  
Feina Shi ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Web Of Science ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Exclusion Criteria ◽  
Total Resection ◽  
Free Survival

BackgroundIt still remains unclear whether patients with atypical meningioma (AM) could benefit from postoperative adjuvant radiotherapy (PORT) after gross-total resection (GTR).ObjectiveExploring the effectiveness of PORT on AM patients after GTR.MethodsLiteratures on PubMed, Embase, Web of science, and Scopus databases published between January 2000 and January 2019 were searched. After the selection based on the certain exclusion criteria, the Newcastle-Ottawa evaluation scale was used to evaluate the quality of the included literatures. Finally, a meta-analysis was conducted to analyze the effectiveness of PORT on local control (LC), progression-free survival (PFS) and overall survival (OS) in atypical meningioma patients after GTR.ResultsA total of 17 articles with 2,008 AM patients were included in the meta-analysis. The 5-year LC, 5-year PFS, and 5-year OS rates were 82.2, 84.1, and 79.0%, respectively, for AM patients receiving PORT after GTR, and they were 71.0, 71.9, and 81.5%, respectively, for those not receiving PORT after GTR. PORT could significantly improve 5-year LC rate (OR [95% Cl] = 2.59 [1.40–4.81], P = 0.002) and 5-year PFS rate (OR [95% Cl] = 1.99 [1.35–2.95], P = 0.001), but did not significantly improve 5-year OS rate (OR [95% Cl] = 1.07 [0.60–1.91], P = 0.828).ConclusionPORT could improve the 5-year LC rate and 5-year PFS rate in AM patients after GTR. AM patients might benefit from PORT after GTR.

scholarly journals Adjuvant radiotherapy versus observation following gross total resection for atypical meningioma: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Se-Woong Chun ◽  
Kyung Min Kim ◽  
Min-Sung Kim ◽  
Ho Kang ◽  
Yun-Sik Dho ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Recurrence Rate ◽  
Adjuvant Radiotherapy ◽  
Local Recurrence Rate ◽  
Meta Analysis ◽  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Survival Outcomes ◽  
Total Resection ◽  
The Impact

Abstract Background The impact of adjuvant radiotherapy (RT) on atypical meningioma (AM) underwent a gross total resection (GTR) remains unclear, showing conflicting results from various studies. The objective of this study was to perform an updated meta-analysis for observational studies to determine the effect of adjuvant RT after GTR on local recurrence and survival outcomes compared to observation after GTR. Methods PubMed, Embase, and Web of Science were searched to identify comparative studies that reported outcomes of adjuvant RT versus observation for AM patients after GTR. Local recurrence rate, progression-free survival (PFS), overall survival (OS), and toxicities related to RT were considered as outcomes of interest. Differences between two cohorts were estimated by calculating odds ratios (OR) for LR rate and hazard ratios (HR) for survival outcomes with 95% confidence intervals (CIs) for meta-analysis, using R version 4.0.3 software. Included studies were appraised with the Risk of Bias Assessment tool for Non-Randomized Studies. Outcome ratios were combined with the Mantel–Haenszel method and the inverse variance-weighted method, appropriately. Results Data from 30 studies involving 2904 patients (adjuvant RT: n = 737; observation: n = 2167) were eventually included. Significant reduction of local recurrence rate was seen in the adjuvant RT cohort compare to that in the observation cohort (OR 0.50; 95% CI 0.36–0.68; p < 0.0001). Pooled HRs of PFS at 1-year, 3-year, 5-year, and > 5-year revealed that adjuvant RT was superior to observation. There was no significant difference in OS between the two cohorts during any period. Most toxicities were tolerable with grade 1 or 2. There was no documented grade 5 toxicity. Conclusions For AM patients who underwent GTR, evidence suggested that adjuvant RT could potentially decrease local recurrence and improve PFS better than observation.

scholarly journals Adjuvant radiotherapy improves progression-free survival in intracranial atypical meningioma

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Saman Moritz Hemmati ◽  
Pirus Ghadjar ◽  
Arne Grün ◽  
Harun Badakhshi ◽  
Sebastian Zschaeck ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Progression Free Survival ◽  
Atypical Meningioma ◽  
Free Survival

scholarly journals Predictive value of two polymorphisms in ABCB1, rs1045642 and rs1128503, in prognosis following taxane-containing chemotherapy: A meta-analysis

2020 ◽  
Author(s):  
Quanyao Chen ◽  
Wanlong Lin ◽  
Jianhui Yang ◽  
Min Lin ◽  
Xiuxian Lin ◽  
...  
Keyword(s):  
Web Of Science ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
China National Knowledge Infrastructure ◽  
Poor Overall Survival ◽  
Free Survival ◽  
Treatment Regimens ◽  
Knowledge Infrastructure ◽  
Chemotherapeutic Response ◽  
Tumor Types

Abstract Background: Although taxane-containing chemotherapy is widely used to treat solid tumors, genetic polymorphisms can influence the chemotherapeutic response. This meta-analysis was conducted to determine the correlation between two polymorphisms in ABCB1 , rs1045642 and rs1128503, and survival of patients administered taxane-containing chemotherapy. Methods: PubMed, Web of Science, Embase, Wanfang database, VIP database, and China National Knowledge Infrastructure database were used to obtain articles published up to August 2019 describing the association between the ABCB1 rs1045642 and rs1128503 polymorphisms and survival. A meta-analysis was conducted using R 3.6.1 software to determine the pooled hazard ratio (HR) and 95% confidence intervals (95% CI). Furthermore, publication bias was assessed, and sensitivity analysis was performed to validate the analysis. Results: Fifteen studies involving 3320 patients were included in the meta-analysis. The summary results showed that the effect of the C1236T polymorphism on progression-free survival remained significant in the heterozygote model (HR 0.81; 95% CI: 0.67–0.98) and homozygote model (HR 0.71; 95% CI: 0.58–0.88). Compared to the C1236 TT phenotype, the CC genotype was associated with a poor overall survival (HR 0.72; 95% CI: 0.53–0.97). Finally, subgroup analysis suggested that different areas, tumor types, and treatment regimens influence patient survival. Conclusions: Patients who are ABCB1 rs1045642 and rs1128503 T gene carriers show a survival benefit with taxane-containing chemotherapy.

Pediatric Clival Chordoma: A Curable Disease that Conforms to Collins' Law

Neurosurgery ◽  
2017 ◽  
Vol 82 (5) ◽  
pp. 652-660 ◽  
Author(s):  
Marcio S Rassi ◽  
M Maher Hulou ◽  
Kaith Almefty ◽  
Wenya Linda Bi ◽  
Svetlana Pravdenkova ◽  
...  
Keyword(s):  
Overall Survival ◽  
Skull Base ◽  
Proton Beam ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Gross Total Resection ◽  
Total Resection ◽  
Free Survival ◽  
Proton Beam Radiotherapy ◽  
Skull Base Chordomas

Abstract BACKGROUND Skull base chordomas in children are extremely rare. Their course, management, and outcome have not been defined. OBJECTIVE To describe the preeminent clinical and radiological features in a series of pediatric patients with skull base chordomas and analyze the outcome of a cohort who underwent uniform treatment. We emphasize predictors of overall survival and progression-free survival, which aligns with Collins’ law for embryonal tumors. METHODS Thirty-one patients with a mean age of 10.7 yr (range 0.8-22) harboring skull base chordomas were evaluated. We retrospectively analyzed the outcomes and prognostic factors for 18 patients treated by the senior author, with uniform management of surgery with the aim of gross total resection and adjuvant proton-beam radiotherapy. Mean follow-up was 119.2 mo (range 8-263). RESULTS Abducens nerve palsy was the most common presenting symptom. Imaging disclosed large tumors that often involve multiple anatomical compartments. Patients undergoing gross total resection had significantly increased progression-free survival (P = .02) and overall survival (P = .05) compared with those having subtotal resection. Those who lived through the period of risk for recurrence without disease progression had a higher probability of living entirely free of progression (P = .03; odds ratio = 16.0). Age, sex, and histopathological variant did not yield statistical significance in survival. CONCLUSION Long-term overall and progression-free survival in children harboring skull base chordomas can be achieved with gross surgical resection and proton-beam radiotherapy, despite an advanced stage at presentation. Collins’ law does apply to pediatric skull base chordomas, and children with this disease have a high hope for cure.

Spinal ependymoma in adults: a multicenter investigation of surgical outcome and progression-free survival

2018 ◽  
Vol 28 (6) ◽  
pp. 654-662 ◽  
Author(s):  
Maria Wostrack ◽  
Florian Ringel ◽  
Sven O. Eicker ◽  
Max Jägersberg ◽  
Karl Schaller ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Progression Free Survival ◽  
Adult Patients ◽  
Gross Total Resection ◽  
Adjuvant Radiation ◽  
Total Resection ◽  
Ki 67 ◽  
Who Grade ◽  
Free Survival ◽  
Spinal Ependymoma

OBJECTIVESpinal ependymomas are rare glial neoplasms. Because their incidence is low, only a few larger studies have investigated this condition. There are no clear data concerning prognosis and therapy. The aim of the study was to describe the natural history, perioperative clinical course, and local tumor control of adult patients with spinal ependymomas who were surgically treated under modern treatment standards.METHODSThe authors performed a multicenter retrospective study. They identified 158 adult patients with spinal ependymomas who had received surgical treatment between January 2006 and June 2013. The authors analyzed the clinical and histological aspects of these cases to identify the predictive factors for postoperative morbidity, tumor resectability, and recurrence.RESULTSGross-total resection (GTR) was achieved in 80% of cases. At discharge, 37% of the patients showed a neurological decline. During follow-up the majority recovered, whereas 76% showed at least preoperative status. Permanent functional deterioration remained in 2% of the patients. Transient deficits were more frequent in patients with cervically located ependymomas (p = 0.004) and in older patients (p = 0.002). Permanent deficits were independently predicted only by older age (p = 0.026). Tumor progression was observed in 15 cases. The 5-year progression-free survival (PFS) rate was 80%, and GTR (p = 0.037), WHO grade II (p = 0.009), and low Ki-67 index (p = 0.005) were independent prognostic factors for PFS. Adjuvant radiation therapy was performed in 15 cases. No statistically relevant effects of radiation therapy were observed among patients with incompletely resected ependymomas (p = 0.079).CONCLUSIONSDue to its beneficial value for PFS, GTR is important in the treatment of spinal ependymoma. Gross-total resection is feasible in the majority of cases, with acceptable rates of permanent deficits. Also, Ki-67 appears to be an important prognostic factor and should be included in a grading scheme for spinal ependymomas.

scholarly journals Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangji Li ◽  
Tong Wu ◽  
Mengmeng Xiao ◽  
Shanshan Wu ◽  
Li Min ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Web Of Science ◽  
Meta Analysis ◽  
Evidence Base ◽  
Cochrane Library ◽  
Free Survival ◽  
Hazard Ratios ◽  
Promising Treatment ◽  
Retroperitoneal Sarcomas

Abstract Background Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study was to evaluate the effectiveness of adjuvant therapy in the management of RPS patients. Methods We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until December 2020) of adjuvant therapy versus surgery alone. Data on the following endpoints were evaluated: overall survival (OS), local recurrence (LR), recurrence-free survival (RFS), and metastasis-free survival (MFS). Data were summarized as hazard ratios (HR) with 95% confidence intervals (CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests. Results A total of 15 trials were eligible, including 9281 adjuvant therapy and 21,583 surgery alone cases (20 studies for OS, six studies for RFS, two studies for LR, and two studies for MFS). Meta-analysis showed that ART was associated with distinct advantages as compared to surgery alone, including a longer OS (HR = 0.80, P < 0.0001), a longer RFS (HR = 0.61, P = 0.0002), and a lower LR (HR = 0.31, P = 0.005). However, this meta-analysis failed to demonstrate a benefit of ACT for RPS patients, including OS (HR = 1.11, P = 0.19), RFS (HR = 1.30, P = 0.09) and MFS (HR = 0.69, P = 0.09). In the sensitivity analysis, ACT was associated with a worse OS (HR = 1.19, P = 0.0002). No evidence of publication bias was observed. Conclusions Overall, the quality of the evidence was moderate for most outcomes. The evidence supports that ART achieved a generally better outcome as compared to surgery alone.

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