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.
|Number of pages||9|
|Journal||Journal of Neuro-Oncology|
|Publication status||Published - 2023 Jan|
Bibliographical noteFunding Information:
Statistical analysis was supported by the Medical Research Collaborating Center of SMG-SNU Boramae Medical Center.
This study was supported by Grant No. 03-2022-2060 received by Chan Woo Wee from the Seoul National University Hospital (SNUH) Research Fund.
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Cancer Research