Dose–response relationship in patients with newly diagnosed atypical meningioma treated with adjuvant radiotherapy

Dowook Kim, Won Ick Chang, Hwa Kyung Byun, In Ah Kim, Jaeho Cho, Joo Ho Lee, Hong In Yoon, Chan Woo Wee

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study aimed to identify the radiation dose–response relationship in patients with newly diagnosed atypical meningioma (AM) treated with adjuvant radiotherapy (ART) using conventional fractionation. Methods: In total, 158 patients who underwent surgery and ART between 1998 and 2018 were reviewed. Among these patients, 135 with complete information on radiotherapy (RT) dose/fractionation and pathological reports were analyzed. We entered RT dose as a continuous variable into the Cox regression model using penalized spline to allow for a nonlinear relationship between RT dose and events. Local control (LC), progression-free survival (PFS), and overall survival (OS) were evaluated. The corresponding biological equivalent dose in 2 Gy fractions (EQD2) was calculated using an α/β ratio of 4 Gy. Results: The median follow-up duration was 56.0 months. The median ART dose delivered was 61.2 Gy in 24–34 daily fractions, corresponding to a median EQD2 of 59.16 Gy. In multivariate analysis, larger size and higher mitotic count were associated with significantly reduced LC (P < 0.001 and P = 0.002, respectively), PFS (P < 0.001 and P = 0.006, respectively), and OS (P = 0.006 and P = 0.001, respectively). Meanwhile, a higher RT dose was significantly associated with improved LC, PFS, and OS. Moreover, RT showed a dose-dependent effect on LC, PFS, and OS; local failure, tumor progression, and death were reduced by 12%, 12%, and 16%, respectively, per 1 Gy increase in the dose (EQD2). Conclusion: The dose of ART in AM has a dose–response relationship with LC and survival outcomes.

Original languageEnglish
Pages (from-to)329-337
Number of pages9
JournalJournal of Neuro-Oncology
Volume161
Issue number2
DOIs
Publication statusPublished - 2023 Jan

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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