成人颅内高级别脑膜瘤的长期随访研究

【摘要】目的评估不同治疗策略下高级别脑膜瘤患者的临床预后情况，探讨未来前瞻性研究的相关指标。方法回顾性分析206例高级别脑膜瘤患者的流行病学、诊断、治疗、复发信息和生存数据。结果本组患者总体而言，中位无进展生存期（PFS）为3.9年，中位总生存期(OS)为9.7年。手术切除范围不仅对提高患者的生存率具有重要意义（全切除vs部分切除患者的中位生存期分别为11.7年和3.9年，P=0.002 9），而且对提高PFS（5.3年vs 2.8年，P=0.003）也有帮助。组织学分级与预后似乎有关联，但没有发现有统计学意义的差异。观察组与放疗组之间的生存率无明显的统计学差异，而在PFS上存在差异(3.5年vs 5.7年，P=0.04)。结论无论高级别脑膜瘤肿瘤组织学亚型如何，手术切除的范围与预后相关。复发性高级别脑膜瘤仍具挑战，迄今为止没有明确有效的化疗药物。

Abstract： ObjectiveTo evaluate the clinical prognosis of patients with high-grade meningioma under different treatment strategies, and to explore the relevant indicators for future prospective research. MethodsThe epidemiology, diagnosis, treatment, recurrence information and survival data of 206 patients with high-grade meningioma were analyzed retrospectively. Results Overall, the median progression free survival(PFS) was 3.9 years, and the median overall survival(OS) was 9.7 years. The extent of resection showed an important significance over survival of patients with median survival of 11.7 years in gross-total resection compared with 3.9 years in partial resection(P=0.002 9), but also over PFS(5.3 years in gross-total resection vs. 2.8 years in partial resection, P=0.003). Additionally, our analysis demonstrated that the histologic grade seemed to be associated with the prognosis, though no statistically differences were found. There were no statistically significant differences in survival between the group managed with a wait-and-see strategy and the group treated with radiotherapy while a difference on PFS was observed(3.5 years vs 5.7 years, P=0.04). ConclusionsRegardless of the histological subtype of high-grade meningiomas, the extent of surgical resection is related to the prognosis. Recurrent high-grade meningiomas are still challenging, and there is no clear and effective chemotherapy so far.