title: Early postoperative radiotherapy improves progression free survival in patients with grade 2 meningioma.
abstract: BACKGROUND
  Grade 2 meningiomas are a real problem in therapeutic management because of their tendency to reoccur. The most effective treatment is surgery. The role of adjuvant radiotherapy in this disease is still disputed due to its uncertain effect on progression-free survival.
  
  
  OBJECTIVE
  To show that early adjuvant radiotherapy is an effective treatment in patients with grade 2 meningiomas.
  
  
  METHODS
  A retrospective study was performed on all patients operated on for grade 2 meningioma in our center between 1994 and 2011. For every patient, we recorded the age at diagnosis, sex, background of neurofibromatosis type 2 (NF2) or meningiomatosis, location of meningioma, quality of tumor resection and whether the patient received early postoperative radiotherapy. These prognosis factors were studied using statistical tests.
  
  
  RESULTS
  We included 167 patients (94 women, 73 men, sex ratio = 1.28); the mean age at diagnosis was 53.8 years. Twenty-seven patients received early adjuvant radiotherapy after surgery. Patients who received early postoperative radiotherapy had a significantly longer progression-free survival (8.2 years) than patients without radiotherapy (5.7 years, p = 0.04). In multivariate analysis, quality of tumor resection and early postoperative radiotherapy decrease the risk of recurrence of meningioma (p < 0.05).
  
  
  CONCLUSIONS
  Adjuvant radiotherapy is an important therapeutic tool in the treatment of patients with grade 2 meningioma. It delays tumor progression and reduces the need for further surgery. Adjuvant radiotherapy must be considered as a treatment option in oncological multidisciplinary meetings, regardless of the quality of surgical resection.
authors.affiliation: Department of Neurosurgery, Lille University Hospital, rue E. Laine, 59037 Lille cedex, France. rabihdoc@hotmail.com
authors.forename: Rabih
authors.initials: R
authors.lastname: Aboukais
authors.forename: Marc
authors.initials: M
authors.lastname: Baroncini
authors.forename: Fahed
authors.initials: F
authors.lastname: Zairi
authors.forename: Nicolas
authors.initials: N
authors.lastname: Reyns
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Lejeune
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008579:Meningioma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome