목적 : 뇌수막종 환자에서 수술후 방사선치료의 효과를 평가하고 최적의 방사선치료 방법을 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1988년 2월부터 1999년 11월까지 본원에서 뇌수막종으로 수술후 방사선치료를 받은 33명의 환자를 후향적으로 분석하였다. 환자의 나이는 17세부터 68세이었고 중앙값은 53세이었다. 조직학적 분류는 33명의 환자중 이행성이 15명, 수막성이 10명, 혈관주위세포성이 4명, 이형성이 3명, 악성이 1명이었다. 4명은 조직검사만을, 29명은 완전절제술을 시행하였다. 5~7주에 걸쳐 50~60 Gy를 28~35회에 나누어 조사하였다. 추적기간은 12개월~8년이었다. 결과 : 전체 환자에서 5년 및 7년 실질 생존율은 각각 78% 및 67%이었다. 5년 및 7년 무병생존율은 각각 73% 및 61%이었다. 국소제어율은 5년에 83%이었다. 25명의 양성군 환자중 1명만이 국소재발을 나타내었고, 8명의 악성군 환자중 4명이 국소재발을 나타내었다. 조직검사만을 시행한 환자에서 2명이 재발하였고 완전절제술을 시행한 29명의 환자에서 3명이 재발하였다. 조직검사만을 시행한 환자와 완전절제술을 시행한 환자의 생존율은 유의한 차이가 없었다. 60세 미만의 환자가 60세 이상의 환자보다 나은 생존율을 나타내었으나, 이는 통계적으로 유의하지 않았다. 결론 : 수술만을 시행한 환자와 비교하여 수술후 방사선치료를 시행한 환자에서 생존율이 향상됨을 알 수 있었고 뇌수막종 환자에서 수술 후 방사선치료가 안전하고 효과적인 치료방법이라 평가하였다.
목적 : 뇌수막종 환자에서 수술후 방사선치료의 효과를 평가하고 최적의 방사선치료 방법을 알아보고자 함이 본 연구의 목적이다. 대상 및 방법 : 1988년 2월부터 1999년 11월까지 본원에서 뇌수막종으로 수술후 방사선치료를 받은 33명의 환자를 후향적으로 분석하였다. 환자의 나이는 17세부터 68세이었고 중앙값은 53세이었다. 조직학적 분류는 33명의 환자중 이행성이 15명, 수막성이 10명, 혈관주위세포성이 4명, 이형성이 3명, 악성이 1명이었다. 4명은 조직검사만을, 29명은 완전절제술을 시행하였다. 5~7주에 걸쳐 50~60 Gy를 28~35회에 나누어 조사하였다. 추적기간은 12개월~8년이었다. 결과 : 전체 환자에서 5년 및 7년 실질 생존율은 각각 78% 및 67%이었다. 5년 및 7년 무병생존율은 각각 73% 및 61%이었다. 국소제어율은 5년에 83%이었다. 25명의 양성군 환자중 1명만이 국소재발을 나타내었고, 8명의 악성군 환자중 4명이 국소재발을 나타내었다. 조직검사만을 시행한 환자에서 2명이 재발하였고 완전절제술을 시행한 29명의 환자에서 3명이 재발하였다. 조직검사만을 시행한 환자와 완전절제술을 시행한 환자의 생존율은 유의한 차이가 없었다. 60세 미만의 환자가 60세 이상의 환자보다 나은 생존율을 나타내었으나, 이는 통계적으로 유의하지 않았다. 결론 : 수술만을 시행한 환자와 비교하여 수술후 방사선치료를 시행한 환자에서 생존율이 향상됨을 알 수 있었고 뇌수막종 환자에서 수술 후 방사선치료가 안전하고 효과적인 치료방법이라 평가하였다.
Purpose : To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. Materials and Methods : The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institut...
Purpose : To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. Materials and Methods : The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institution between Feb, 1988 and Nov, 1999 were retrospectively analyzed. Median age of patients at diagnosis was 53 years with range of 17 to 68 years. Sites of involvement were parasagital, cerebral convexity, sphenoid ridge, parasellar and tentorium cerebelli. Of 33 evaluated patients, 15 transitional, 10 meningotheliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Four patients underwent biopsy alone and remaining 29 patients underwent total tumor resection. A dose of 50 to 60 Gy was delivered in 28-35 daily fractions over a period of 5 to 7 weeks. Follow-up period ranged from 12 months to 8 years. Results : The actuarial survival rates at 5 and 7 years for entire group of patients were 78% and 67%, respectively. The corresponding disease free survival rates were 73% and 61%, respectively. The overall local control rate at 5 years was 83%. One out of 25 patients in benign group developed local failure, while 4 out of 8 patients in malignant group did local failure (p<0.05). Of 4 patients who underwent biopsy alone, 2 developed local failure. There was no significant difference in 5 year actuarial survival between patients who underwent total tumor resection and those who did biopsy alone. Patients whose age is under 60 showed slightly better survival than those whose age is 60 or older, although this was not statistically significant. There was no documented late complications in any patients. Conclusion : Based on our study, we might conclude that postoperative external beam radiotherapy tends to improve survival of patients with intracranial meningiomas comparing with surgery alone.
Purpose : To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. Materials and Methods : The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institution between Feb, 1988 and Nov, 1999 were retrospectively analyzed. Median age of patients at diagnosis was 53 years with range of 17 to 68 years. Sites of involvement were parasagital, cerebral convexity, sphenoid ridge, parasellar and tentorium cerebelli. Of 33 evaluated patients, 15 transitional, 10 meningotheliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Four patients underwent biopsy alone and remaining 29 patients underwent total tumor resection. A dose of 50 to 60 Gy was delivered in 28-35 daily fractions over a period of 5 to 7 weeks. Follow-up period ranged from 12 months to 8 years. Results : The actuarial survival rates at 5 and 7 years for entire group of patients were 78% and 67%, respectively. The corresponding disease free survival rates were 73% and 61%, respectively. The overall local control rate at 5 years was 83%. One out of 25 patients in benign group developed local failure, while 4 out of 8 patients in malignant group did local failure (p<0.05). Of 4 patients who underwent biopsy alone, 2 developed local failure. There was no significant difference in 5 year actuarial survival between patients who underwent total tumor resection and those who did biopsy alone. Patients whose age is under 60 showed slightly better survival than those whose age is 60 or older, although this was not statistically significant. There was no documented late complications in any patients. Conclusion : Based on our study, we might conclude that postoperative external beam radiotherapy tends to improve survival of patients with intracranial meningiomas comparing with surgery alone.
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문제 정의
This report describes the results of treatment of intracranial meningioma with megavoltage photon irradiation. Because surgery was considered by the referring neurosurgeons to be definitive and enough treatment for completely resected benign meningiomas, it is important to emphasize that the patients in this study represent a population with adverse prognostic factors.
제안 방법
We retrospectively analyzed the records of patients with intracranial meningiomas to evaluate the effectiveness and tolerance of postoperative radiotherapy for these tumors.
대상 데이터
patients. Of the 33 patients in this study, 15 transitional, 10 meningo- theliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Tumors which showed increased mitosis, vessel proliferation, brain necrosis, invasion into brain, deformity of architecture were classified as atypical and malignant type.
성능/효과
The results of postoperative radiotherapy for malignant meningiomas was disappointing, with a high probability of death from disease progression or recurrence of tumor. Review of the literature reveals large variation in results of treatment of these malignant meningionias which is probably due to the small number of cases in each series.
There was no significant difference in 5 year actuarial survival rates between patients who underwent total tumor resection and those who did biopsy alone (80% vs 75%). Patients whose age is under 60 showed better survival than those whose age is 60 or dei (80% vs 69%, p>0.
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