Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma

Jason Joon Bock Lee, Jeongshim Lee, Hong In Yoon, Se Hoon Kim, Jaeho Cho, Kyu Sung Lee, Jong Hee Chang, Chang Ok Suh

Research output: Contribution to journalArticle

Abstract

Purpose: To analyze patterns of failure according to treatment modalities and evaluate the adequacy of an institution’s current volume of postoperative radiotherapy (PORT) for World Health Organization (WHO) grade II or III meningiomas. Patients and methods: Data of 98 patients treated by either surgery and PORT (PORT group, n = 53) or surgery alone (surgery group, n = 45) between March 2000 and December 2013 were reviewed. Clinical target volume of PORT was delineated as a 1.5–2-cm expansion from the tumor bed. Local failure (LF) was defined as recurrence within a 2-cm margin from the tumor bed. Failures other than LF were defined as out-field failure (OFF). Median total dose of PORT was 59.4 (range 45.0–69.0) Gy. Results: The PORT group had larger proportions of grade III meningiomas (18/53, 34.0%) than the surgery group (8/46, 15.6%) (p = 0.037). After a median 73.4-month follow-up, 29 patients experienced LF and 5 developed OFF. The actuarial 5-year local control (LC) rates were 86.7% and 59.3% in the PORT and surgery groups, respectively (p = 0.002). PORT was a significant factor of LC in the univariate (p = 0.003, hazard ratio [HR] 3.449, 95% confidence interval [CI] 1.516–7.846) and multivariate analyses (p < 0.001, HR 5.486, 95% CI 2.178–13.820). Conclusions: Despite the larger proportion of grade III meningiomas in the PORT group, PORT reduced LF in patients with WHO grade II or III meningiomas compared with the surgery group. The current PORT field seems reasonable because LF was the dominant pattern of failure in patients treated by surgery alone.

Original languageEnglish
Pages (from-to)333-341
Number of pages9
JournalJournal of Neuro-Oncology
Volume144
Issue number2
DOIs
Publication statusPublished - 2019 Sep 1

Fingerprint

Meningioma
Radiotherapy
Radiation
Confidence Intervals
Neoplasms
Multivariate Analysis
Recurrence

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Lee, Jason Joon Bock ; Lee, Jeongshim ; Yoon, Hong In ; Kim, Se Hoon ; Cho, Jaeho ; Lee, Kyu Sung ; Chang, Jong Hee ; Suh, Chang Ok. / Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma. In: Journal of Neuro-Oncology. 2019 ; Vol. 144, No. 2. pp. 333-341.
@article{2f636e01dccd4e86a4f747a2f87e1cca,
title = "Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma",
abstract = "Purpose: To analyze patterns of failure according to treatment modalities and evaluate the adequacy of an institution’s current volume of postoperative radiotherapy (PORT) for World Health Organization (WHO) grade II or III meningiomas. Patients and methods: Data of 98 patients treated by either surgery and PORT (PORT group, n = 53) or surgery alone (surgery group, n = 45) between March 2000 and December 2013 were reviewed. Clinical target volume of PORT was delineated as a 1.5–2-cm expansion from the tumor bed. Local failure (LF) was defined as recurrence within a 2-cm margin from the tumor bed. Failures other than LF were defined as out-field failure (OFF). Median total dose of PORT was 59.4 (range 45.0–69.0) Gy. Results: The PORT group had larger proportions of grade III meningiomas (18/53, 34.0{\%}) than the surgery group (8/46, 15.6{\%}) (p = 0.037). After a median 73.4-month follow-up, 29 patients experienced LF and 5 developed OFF. The actuarial 5-year local control (LC) rates were 86.7{\%} and 59.3{\%} in the PORT and surgery groups, respectively (p = 0.002). PORT was a significant factor of LC in the univariate (p = 0.003, hazard ratio [HR] 3.449, 95{\%} confidence interval [CI] 1.516–7.846) and multivariate analyses (p < 0.001, HR 5.486, 95{\%} CI 2.178–13.820). Conclusions: Despite the larger proportion of grade III meningiomas in the PORT group, PORT reduced LF in patients with WHO grade II or III meningiomas compared with the surgery group. The current PORT field seems reasonable because LF was the dominant pattern of failure in patients treated by surgery alone.",
author = "Lee, {Jason Joon Bock} and Jeongshim Lee and Yoon, {Hong In} and Kim, {Se Hoon} and Jaeho Cho and Lee, {Kyu Sung} and Chang, {Jong Hee} and Suh, {Chang Ok}",
year = "2019",
month = "9",
day = "1",
doi = "10.1007/s11060-019-03232-w",
language = "English",
volume = "144",
pages = "333--341",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "2",

}

Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma. / Lee, Jason Joon Bock; Lee, Jeongshim; Yoon, Hong In; Kim, Se Hoon; Cho, Jaeho; Lee, Kyu Sung; Chang, Jong Hee; Suh, Chang Ok.

In: Journal of Neuro-Oncology, Vol. 144, No. 2, 01.09.2019, p. 333-341.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of patterns of failure and appraisal of postoperative radiation field for grade II–III meningioma

AU - Lee, Jason Joon Bock

AU - Lee, Jeongshim

AU - Yoon, Hong In

AU - Kim, Se Hoon

AU - Cho, Jaeho

AU - Lee, Kyu Sung

AU - Chang, Jong Hee

AU - Suh, Chang Ok

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Purpose: To analyze patterns of failure according to treatment modalities and evaluate the adequacy of an institution’s current volume of postoperative radiotherapy (PORT) for World Health Organization (WHO) grade II or III meningiomas. Patients and methods: Data of 98 patients treated by either surgery and PORT (PORT group, n = 53) or surgery alone (surgery group, n = 45) between March 2000 and December 2013 were reviewed. Clinical target volume of PORT was delineated as a 1.5–2-cm expansion from the tumor bed. Local failure (LF) was defined as recurrence within a 2-cm margin from the tumor bed. Failures other than LF were defined as out-field failure (OFF). Median total dose of PORT was 59.4 (range 45.0–69.0) Gy. Results: The PORT group had larger proportions of grade III meningiomas (18/53, 34.0%) than the surgery group (8/46, 15.6%) (p = 0.037). After a median 73.4-month follow-up, 29 patients experienced LF and 5 developed OFF. The actuarial 5-year local control (LC) rates were 86.7% and 59.3% in the PORT and surgery groups, respectively (p = 0.002). PORT was a significant factor of LC in the univariate (p = 0.003, hazard ratio [HR] 3.449, 95% confidence interval [CI] 1.516–7.846) and multivariate analyses (p < 0.001, HR 5.486, 95% CI 2.178–13.820). Conclusions: Despite the larger proportion of grade III meningiomas in the PORT group, PORT reduced LF in patients with WHO grade II or III meningiomas compared with the surgery group. The current PORT field seems reasonable because LF was the dominant pattern of failure in patients treated by surgery alone.

AB - Purpose: To analyze patterns of failure according to treatment modalities and evaluate the adequacy of an institution’s current volume of postoperative radiotherapy (PORT) for World Health Organization (WHO) grade II or III meningiomas. Patients and methods: Data of 98 patients treated by either surgery and PORT (PORT group, n = 53) or surgery alone (surgery group, n = 45) between March 2000 and December 2013 were reviewed. Clinical target volume of PORT was delineated as a 1.5–2-cm expansion from the tumor bed. Local failure (LF) was defined as recurrence within a 2-cm margin from the tumor bed. Failures other than LF were defined as out-field failure (OFF). Median total dose of PORT was 59.4 (range 45.0–69.0) Gy. Results: The PORT group had larger proportions of grade III meningiomas (18/53, 34.0%) than the surgery group (8/46, 15.6%) (p = 0.037). After a median 73.4-month follow-up, 29 patients experienced LF and 5 developed OFF. The actuarial 5-year local control (LC) rates were 86.7% and 59.3% in the PORT and surgery groups, respectively (p = 0.002). PORT was a significant factor of LC in the univariate (p = 0.003, hazard ratio [HR] 3.449, 95% confidence interval [CI] 1.516–7.846) and multivariate analyses (p < 0.001, HR 5.486, 95% CI 2.178–13.820). Conclusions: Despite the larger proportion of grade III meningiomas in the PORT group, PORT reduced LF in patients with WHO grade II or III meningiomas compared with the surgery group. The current PORT field seems reasonable because LF was the dominant pattern of failure in patients treated by surgery alone.

UR - http://www.scopus.com/inward/record.url?scp=85068878505&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068878505&partnerID=8YFLogxK

U2 - 10.1007/s11060-019-03232-w

DO - 10.1007/s11060-019-03232-w

M3 - Article

C2 - 31278690

AN - SCOPUS:85068878505

VL - 144

SP - 333

EP - 341

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 2

ER -