Fractionated radiotherapy adjuvant to surgery of WHO-2 meningioma with and without gross total resection: a multicenter, retrospective cohort study of 1,452 patients

作者：Christian Mirian, Lasse Rehné Jensen, Hoffmann Al, Tareq A. Juratli, Andrea Daniela Maier, Pernilla Lindner, Anders Broechner, Sverre H. Torp, Helen A. Shih, Ramin A. Morshed, Jacob S. Young, Stephen T Magill, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Ricardo Prat-Acín, Stéphane Goutagny, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Y Z Kim, Joo Ho Lee, D. Kim, Matthew Koshy, Donald M. Cannon, Dennis C. Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y. Eyüpoglu, Tony Catalan, Austin Lui, Philip V. Theodosopoulos, Michael W McDermott, Pedro Góes, Fang Wang, Luís Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Tejpal Gupta, Akash J. Patel, Tiemo J Klisch, Jun Won Kim, F Maiuri, Valeria Barresi, Tabernero, Simon Skyrman, M Krause, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein R. Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen · 发表于：Journal of Neuro-Oncology · 年份：2026 · DOI：10.1007/s11060-025-05349-7 · 被引用次数：2 · 研究领域：Meningioma and schwannoma management、Brain Metastases and Treatment、Glioma Diagnosis and Treatment

PURPOSE: The role of adjuvant fractionated radiotherapy (aFRT) after gross total resection (GTR) of WHO-2 meningiomas remains unclear. We aimed to estimate the effect of aFRT on recurrence risk and survival following GTR and subtotal resection (STR). METHODS: We analyzed 1452 patients with WHO-2 from our international, multicenter database (followed between 1989 and 2019). Outcomes were recurrence (10-year follow-up) and death (5-year follow-up). Risk estimates were obtained using competing risks and survival analysis. Average treatment effects were estimated by G-computation, adjusted for potential confounding by age, sex, Simpson grade, Ki-67 proliferation index, location, country group (universal healthcare or not), and year of treatment initiation. The robustness of findings was examined through sensitivity analyses. RESULTS: Overall, 276 of 1452 patients (19.0%) received aFRT. Among GTR patients, unadjusted analysis showed comparable recurrence proportions between irradiated and non-irradiated patients (25.5% vs. 22.8% within 5 years). Adjusted analyses provided no evidence that aFRT reduced the risk of recurrence (largest difference: −2.7%, 95% CI −5.6 to 0.2); although, the CIs include the possibility of small beneficial effects. In STR patients, aFRT was associated with reduced recurrence risk in both unadjusted and adjusted analyses. Unexpectedly, a higher mortality was observed among irradiated GTR patients, largely driven by older patients with low Ki-67 PI receivi...