Atipik menengiomlarda tedavi modalitelerinin değerlendirilmesi

Menengiomlar araknoid kap hücrelerinden köken alan yavaş büyüyen santral sinir sistemi tümörleridir. Atipik (WHO Grade II) menengiomlar tüm menengiomların %15-20sini oluşturmaktadır ve daha agresif, derecesi yüksek olan bu tip menengiomların tedavisi zordur. Grade II ve III menengiomlarda morbidite, mortalite ve rekürrens daha yüksek, sağkalım ise daha kısadır, ancak tedavi planlaması iyi yapılırsa lokal rekürrens %38-68 oranında sağlanabilmektedir. Hastanın yaşı (

Assessment of treatment modalities in atypical meningiomas

Meningiomas are benign, slow growing central nerve system tumors that originate from arachnoid cap cells. Atypical (WHO grade II) meningiomas comprise 15-20% of all meningiomas and management of this more aggressive and higher grade tumor is difficult. Although recurrence, morbidity, mortality rates are high and survival is short in grade II and III meningiomas, 38-68 % local control rate can be provided with an efficient treatment strategy. Age of patient (<50) and extension of surgical removal is directly correlated with survival.

PDF

___

1. Choy W, Won K, Nagasawa D, Stramotas S, Yew A.al. The molecular genetics and tumor pathogenesismeningiomas and the future directions of meningioma treatments. Neurosurg Focus 2011;30(5):E6(1-12).
2. Riemenschneider MJ, Perry A, Reifenberger Histological classification and molecular genetics meningiomas. Lancet Neurol 2006;5:1045-1054.
3. Aghi MK, Carter BS, Cosgrove GR, et al. Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation. Neurosurgery 2009;64(1):56-60.
4. Smith SJ, Boddu S, Macarthur DC. Atypical meningiomas: WHO moved the goalposts? BrNeurosurg 2007;21:588-592.
5. Perry A, Louis DN, Scheithauer BW, Budka Von Demling A. Meningeal tumors. In:Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, eds. WHO classification of tumors of the central nervous system. Lyon:IARC Press; 2007:164-172.
6. Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW: Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. J Neurol Neurosurg Psychiatry 2008;79:574-580.
7. Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957;20(1):22-39.
8. Kobayashi K, Okudera H, Tanaka Y. Surgical considerationsnon skull base meningioma. Presented at the First International Skull Base Congress, Hanover, Germany, June 18, 1922.
9. Kinjo T, Al-Mefty O, Kanaan I. Grade zero removal supratentorial convexity meningiomas. Neurosurgery 1993;33:394-399.
10. Walcott BP, Nahed BV, Brastianos PK, Loeffler JS. Radiation treatment for WHO grade II andmeningiomas. Frontiers in Oncology 2013;3(227):1- 6.
11. Mair R, Morris K, Scott I, Carroll TA. Radiotherrapy atypical meningiomas. J Neurosurg 2011;115:811- 819.
12. Simon M, Bostrom J, Koch P, Schramm Interinstitutional variance of postoperative radiotherapy and follow up for meningiomas in Germany: impact of changes of the WHO classification. J Neurol Neurosurg Psychiatry 2006;77:767-773.
13. Marcus HJ, Price SJ, Wilby M, SantariusKirollos RW. Radiotherapy as an adjuvant in the management of intracranial meningiomas: are we practicing evidence-based medicine? Br J Neurosurg 2003;22:520-528.
14. Dietrich J, Monje M, Wefel J, Meyers C. Clinical patterns and biological correlates of cognitive dysfunction associated with cancer therapy. Oncologist 2008;13(12):1285-1295.
15. Goldsmith BJ, Wara WM, Wilson CB, Larson DA. Postoperative irradiation for subtotally resected meningiomas. A retrospective analysis of 140 patients treated from 1967 to 1990. J Neurosurg 1994;80:195-201.
16. Lawrence YR, Li XA, el Naqa I, Hahn CA, Marks LB, Merchant TE et al. Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys 76 (3 suppl) 2010;S20-S27.
17. Hakim R, Alexander E III, Loeffler JS, et al. Results of linear accelerator-based radiosurgery for intracranial meningiomas. Neurosurgery 1998;42(3):446-453.
18. Harris AE, Lee JYK, Omalu B, Flickinger JC, Kondziolka D, Lunsford LD. The effect of radiosurgery during management of aggressive meningiomas. Surg Neurol 2003;60:298-305.
19. Violaris K, Katsarides V, Karakyriou M, Sakellariou P. Surgical outcome of treating grades II and III meningiomas: a report of 32 cases. Neuroscience Journal 2013, doi: 10.1155/2013/706481
20. Pollock BE. Defining the best management for patients with intracranial world health organization grade II meningiomas. World Neurosurg 2013, doi:10.1016/2013.08.051.
21. Attia A, Chan MD, Mott RT, Russell GB, Seif D, Bourland JD et al. Patterns of failure after treatment of atypical meningioma with gamma knife radiosurgery. J Neurooncol 2012;108:179-185.
22. Ware ML, Larson DA, Sneed PK, Wara WW, McDermott MW. Surgical resection and permanent brachytherapy for recurrent atypical and malignant meningioma. Neurosurgery 2004;54(1):55-64.
23. Grunberg SM, Weiss M. Lack of efficacy of megestrol acetate in the treatment of unresectable meningioma. J Neurooncol 1990;8:61-65.
24. Goodwin JW, Crowley J, Eyre HJ et al. A phase II evaluation of tamoxifen unresectable or refractory meningiomas: a Southwest Oncology Group Study. J Neurooncol 1993;15:73-77.
25. Chamberlain MC, Glantz MJ, Fadul CE. Recurrent meningioma: a salvage therapy with sandostatin. Int J Radiat Oncol Biol Phys 2007;42:431-436.
26. Zaher A, Mattar MA,Zayed DH, Ellatif RA, Ashamallah. Atypical meningioma: a study of prognostic factors. World Neurosurg 2013;80(5):549-553.
27. Kaur G, Sayegh ET, Larson A, Bloch O, Madden M, Sun MZ, Barani IJ, James CD, Parsa AT. Adjuvant radiotherapy for atypical and malignant meningiomas: a systematic review. Neuro Oncol. 2014 May;16(5):628-36. doi: 10.1093/neuonc/ nou025. Epub 2014 Apr 2.