The recurrence of supratentorial meningiomas after surgery

Beks, J. W. F.; Windt, H. L. de

doi:10.1007/bf01793074

Cited by 68 publications

(31 citation statements)

References 4 publications

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“…There was a significant absolute shrinkage at two-year compared to one-year follow-up as well (V change mean ¼ À1.3 ± 1.8 cm 3 , p¼ .038). There was no significant difference in TV changes between IMRT-and FSRTtreated patients (Figures 2 and 3 Figure 5).…”

Section: Resultsmentioning

confidence: 96%

“…The reason could be the increased proliferation and decreased regeneration of anaplastic cells leading to higher radiation sensitivity. On the contrary, higher grade is stated to be a negative prognostic factor in respect of DFS and OS [1,3,6,12].…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, the GTV was delineated on the initial pre-therapeutical MRI as well as on the first-and second-year followup MRIs in cooperation of two experienced radiation oncologists using Siemens Dosimetrist (Siemens Medical Solutions, Concord, CA). Afterwards, these three GTVs (pretherapeutical, first-and second-year follow-up) were compared and tumor volumes (TV) were calculated in cm 3 (Masterplan Oncentra, Nucletron, Columbia, MD).…”

Section: Methodsmentioning

confidence: 99%

“…Gross total resection (GTR) provides long-term recurrencefree survival in many cases [3,4]. If only subtotal resection (STR) can be achieved or in cases of grade II tumors, adjuvant radiotherapy (RT) should be considered.…”

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confidence: 99%

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Volumetric response of intracranial meningioma after photon or particle irradiation

et al. 2016

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Background: Meningiomas are usually slow growing, well circumscribed intracranial tumors. In symptom-free cases observation with close follow-up imaging could be performed. Symptomatic meningiomas could be surgically removed and/or treated with radiotherapy. The study aimed to evaluate the volumetric response of intracranial meningiomas at different time points after photon, proton, and a mixed photon and carbon ion boost irradiation. Patients and methods: In Group A 38 patients received proton therapy (median dose: 56 GyE in 1.8-2 GyE daily fractions) or a mixed photon/carbon ion therapy (50 Gy in 2 Gy daily fractions with intensity modulated radiotherapy (IMRT) and 18 GyE in 3 GyE daily dose carbon ion boost). Thirty-nine patients (Group B) were treated by photon therapy with IMRT or fractionated stereotactic radiotherapy technique (median dose: 56 Gy in 1.8-2 Gy daily fractions). The delineation of the tumor volume was based on the initial, one-and two-year follow-up magnetic resonance imaging and these volumes were compared to evaluate the volumetric tumor response. Results: Significant tumor volume shrinkage was detected at one-and at two-year follow-up both after irradiation by particles and by photons. No significant difference in tumor volume change was observed between photon, proton or combined photon plus carbon ion boost treated patients. WHO grade and gender appear to be determining factors for tumor volume shrinkage. Conclusion: Significant volumetric shrinkage of meningiomas could be observed independently of the applied radiation modality. Long-term follow-up is recommended to evaluate further dynamic of size reduction and its correlation with outcome data.

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Section: Resultsmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Volumetric response of intracranial meningioma after photon or particle irradiation

et al. 2016

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“…Anaplastic meningiomas and a minority of common and intermediate type meningiomas are characterized by aggressive clinical behavior with increased risk of tumor recurrence. However, meningiomas show an unexpectedly high recurrence rate (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Clonal cytogenetic progression within intratumorally heterogeneous meningiomas predicts tumor recurrence

Urbschat

Rahnenführer²,

Henn³

et al. 2011

Int J Oncol

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Abstract. Meningiomas arise from the coverings of the brain or the spinal cord. They are mostly benign and can be surgically cured. However, in approximately 5% of the cases, they turn into malignant forms with aggressive clinical behavior and increased risk of tumor recurrence. Cytogenetically meningiomas are well characterized, with normal karyotype or monosomy of chromosome 22 in most tumors and clinically relevant secondary losses of other autosomes and sex chromosomes in a subset of anaplastic tumors. Statistical analyses were performed for 1064 karyotypes derived from 661 meningiomas with respect to progression, and recurrence of the tumor. The order of accumulating genetic aberrations has previously been biostatistically estimated with oncogenetic tree models, and a genetic progression score derived from these models was shown to be predictive for tumor recurrence. Although more homogeneous than other cancer types, meningiomas show considerable intratumoral cytogenetic heterogeneity, particularly in their anaplastic form. We observed different cytogenetic patterns in tumor cells of 224 out of 661 (33.4%) meningiomas. The present study demonstrates that it is not sufficient to consider only the most frequent cytogenetic pattern observed in a sufficient set of cells derived from the same tumor. Even a single cell with more advanced genetic progression may start a clone and indicates also clinical progression. Cox regression analysis reveals that the clone with most advanced progression is a leading marker for recurrence in meningiomas. The aim of this study was the analysis of genetic heterogeneity on single cell basis. Further we investigated if there is a substantial correlation between the intratumoral heterogeneity of a given meningioma and its recurrence risk. We were able to show that the selection of single genetically advanced cells improves the prediction of clinical meningioma progression in a more precise manner. IntroductionMeningiomas are almost always sporadic and rarely multiple tumors of the brain (1). In their sporadic form, they are typically benign and grow slowly. They appear mostly in the later decades of life. According to a study comprising 661 tumors (2), more than 75% of meningiomas belong to the common type (WHO grade I), ~20% belong to the atypical or intermediate type (WHO grade II) and only ~3% belong to the anaplastic type (WHO grade III). Anaplastic meningiomas and a minority of common and intermediate type meningiomas are characterized by aggressive clinical behavior with increased risk of tumor recurrence. However, meningiomas show an unexpectedly high recurrence rate (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).Between 30 and 60% of meningiomas have a normal karyotype within the tumor cells. Loss of one chromosome 22 is known to be a primary event, but it is difficult to provide evidence for the homozygous loss of a tumor suppressor gene on this chromosome. Approximately 25% of the meningiomas show monosomy 22 as the only aberration in the vast majority of cells. Hypodiplo...

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