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Multimodal management of surgery- and radiation-refractory meningiomas: an analysis of the French national tumor board meeting on meningiomas cohort
- Source :
- Journal of Neuro-Oncology, Journal of Neuro-Oncology, Springer Verlag, 2021, 153 (1), pp.55-64. ⟨10.1007/s11060-021-03741-7⟩, Journal of Neuro-Oncology, 2021, 153 (1), pp.55-64. ⟨10.1007/s11060-021-03741-7⟩
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- International audience; PURPOSE: Meningiomas represent the most frequent tumor of the central nervous system in adults. While most meningiomas are efficiently treated by surgery and radiotherapy/radiosurgery, there is a small portion of radiation- and surgery-refractory tumors for which there is no clear recommendation for optimal management. The French National Tumor Board Meeting on Meningiomas (NTBM) offers a glimpse on the current management of such patients. METHODS: We retrospectively reviewed the charts of patients presented to the multidisciplinary Meeting between 2016 and 2019. We selected patients with a progressive disease after at least two treatments, including surgery and radiotherapy. RESULTS: In this multicentric cohort of 86 cases, patients harbored 17 (19.8%) WHO Grade I, 48 (55.8%) WHO Grade II and 21 (24.4%) WHO Grade III tumors. The median number of treatments received before inclusion was 3 (range: 2 - 11). Following the Board Meeting, 32 patients (37.2%) received chemotherapy, 11 (12.8%) surgery, 17 (19.8%) radiotherapy, 14 (16.3%) watchful observation and 12 (13.9%) palliative care. After a mean follow-up of 13 months post-inclusion, 32 patients (37.2%) had died from their disease. The mean progression free survival was 27 months after radiotherapy, 10 months after surgery, 8.5 months after chemotherapy (Bevacizumab: 9 months - Octreotide/Everolimus: 8 months). CONCLUSIONS: Surgery- and radiation-refractory meningiomas represent a heterogeneous group of tumors with a majority of WHO Grade II cases. If re-irradiation and redo-surgery are not possible, bevacizumab and octreotide-everolimus appear as a valuable option in heavily pre-treated patients considering the current EANO guidelines.
- Subjects :
- Cancer Research
medicine.medical_specialty
Palliative care
Bevacizumab
medicine.medical_treatment
[SDV.CAN]Life Sciences [q-bio]/Cancer
Octreotide
Radiosurgery
Disease-Free Survival
Meningioma
03 medical and health sciences
0302 clinical medicine
Meningeal Neoplasms
medicine
Humans
Everolimus
Progression-free survival
Retrospective Studies
Atypical meningioma
business.industry
medicine.disease
Combined Modality Therapy
3. Good health
Surgery
Radiation therapy
Treatment Outcome
Neurology
Oncology
030220 oncology & carcinogenesis
Cohort
High-grade meningioma
[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
Malignant meningioma
Neurology (clinical)
business
030217 neurology & neurosurgery
Progressive disease
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 15737373 and 0167594X
- Volume :
- 153
- Database :
- OpenAIRE
- Journal :
- Journal of Neuro-Oncology
- Accession number :
- edsair.doi.dedup.....95fac7e11e56ccd197e10f790f6cce95