Adjuvant combined modality therapy for malignant meningiomas

被引:79
作者
Chamberlain, MC
机构
[1] University of California, San Diego, San Diego, CA
[2] University of California, San Diego, San Diego, CA 92093-0812, 9500 Gilman Drive
关键词
malignant meningioma; chemotherapy; radiotherapy;
D O I
10.3171/jns.1996.84.5.0733
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Malignant meningiomas constitute 10% to 15% of all meningiomas and limited information exists regarding adjuvant treatment of these aggressive primary brain tumors. Foul teen patients (eight men, six women), ranging in age from 28 to 61 years (median 51 years), were prospectively treated for primary malignant meningiomas according to an institutional protocol. All patients underwent surgery (gross-total in four and subtotal resection in 10 patients) followed in 2 to 4 weeks by involved-field radiotherapy (range 59-60 Gy, median dose 60 Gy). Two to 4 weeks after radiotherapy all patients were treated with adjuvant chemotherapy that included cyclophosphamide, adriamycin, and vincristine (CAV). Patients who underwent gross-total resection received three cycles, whereas those with subtotal resection received six cycles of CAV. Four patients required CAV dose reduction due to myelosuppression, and in three patients, myelosuppression prevented administration of the planned course of CAV. Four patients required transfusions (four received red blood cells, three received platelets), and two developed neutropenic fever without bacteriological documentation. Neuroradiographic response included three partial responses and 11 with stable disease. The median time to tumor progression was 4.6 years (range 2.2-7.1 years) and median survival was 5.3 years (range 2.6-7.6 years). The author concludes that combined modality therapy for the treatment of malignant meningiomas is associated with acceptable toxicity and a modest improvement in survival when compared to patients treated with surgery alone.
引用
收藏
页码:733 / 736
页数:4
相关论文
共 23 条
[1]   MALIGNANT AND ATYPICAL MENINGIOMAS - A REAPPRAISAL OF CLINICAL, HISTOLOGICAL, AND COMPUTED TOMOGRAPHIC FEATURES [J].
ALVAREZ, F ;
RODA, JM ;
ROMERO, MP ;
MORALES, C ;
SARMIENTO, MA ;
BLAZQUEZ, MG .
NEUROSURGERY, 1987, 20 (05) :688-694
[2]   PREDICTION OF TUMOR DOUBLING TIME IN RECURRENT MENINGIOMAS - CELL-KINETICS STUDIES WITH BROMODEOXYURIDINE LABELING [J].
CHO, KG ;
HOSHINO, T ;
NAGASHIMA, T ;
MUROVIC, JA ;
WILSON, CB .
JOURNAL OF NEUROSURGERY, 1986, 65 (06) :790-794
[3]   THE ROLE OF RADIOTHERAPY IN THE MANAGEMENT OF INTRACRANIAL MENINGIOMAS - THE ROYAL-MARSDEN-HOSPITAL EXPERIENCE WITH 186 PATIENTS [J].
GLAHOLM, J ;
BLOOM, HJG ;
CROW, JH .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1990, 18 (04) :755-761
[4]   POSTOPERATIVE IRRADIATION FOR SUBTOTALLY RESECTED MENINGIOMAS - A RETROSPECTIVE ANALYSIS OF 140 PATIENTS TREATED FROM 1967 TO 1990 [J].
GOLDSMITH, BJ ;
WARA, WM ;
WILSON, CB ;
LARSON, DA .
JOURNAL OF NEUROSURGERY, 1994, 80 (02) :195-201
[5]   TREATMENT OF UNRESECTABLE MENINGIOMAS WITH THE ANTIPROGESTERONE AGENT MIFEPRISTONE [J].
GRUNBERG, SM ;
WEISS, MH ;
SPITZ, IM ;
AHMADI, J ;
SADUN, A ;
RUSSELL, CA ;
LUCCI, L ;
STEVENSON, LL .
JOURNAL OF NEUROSURGERY, 1991, 74 (06) :861-866
[6]  
HOSHINO T, 1986, CANCER, V58, P1466, DOI 10.1002/1097-0142(19861001)58:7<1466::AID-CNCR2820580715>3.0.CO
[7]  
2-W
[8]   CLINICAL PATHOLOGY OF MALIGNANT MENINGIOMAS [J].
INOUE, H ;
TAMURA, M ;
KOIZUMI, H ;
NAKAMURA, M ;
NAGANUMA, H ;
OHYE, C .
ACTA NEUROCHIRURGICA, 1984, 73 (3-4) :179-191
[9]   SEEMINGLY COMPLETE REMOVAL OF HISTOLOGICALLY BENIGN INTRACRANIAL MENINGIOMA - LATE RECURRENCE RATE AND FACTORS PREDICTING RECURRENCE IN 657 PATIENTS - A MULTIVARIATE-ANALYSIS [J].
JAASKELAINEN, J .
SURGICAL NEUROLOGY, 1986, 26 (05) :461-469
[10]   ATYPICAL AND ANAPLASTIC MENINGIOMAS - RADIOLOGY, SURGERY, RADIOTHERAPY, AND OUTCOME [J].
JAASKELAINEN, J ;
HALTIA, M ;
SERVO, A .
SURGICAL NEUROLOGY, 1986, 25 (03) :233-242