The Effects Of Postoperative Radiotherapy On The Prognosis Of Atypical Meningioma:A Meta-analysis

Objective:We made a meta-analysis to explore the effects of postoperative radiotherapy on the prognosis of patients with atypical meningioma.Methods:Two researchers searched Pub Med,EMbase,Web of Science,VIP,Wanfang database and China national knowledge infrastructure(CNKI)to collect literatures about the effects of postoperative radiotherapy on the prognosis of patients with atypical meningioma from the establishment of the database to the publication of the table in January 2020.The lite ratures were screened according to the inclusion or non-exclusion criteri a,the quality of the included literatures was evaluated by Newcastle-Ott awa Quality Assessment Scale(NOS).The Meta-analysis wasoperated byReview Manager 5.3.Results:We included a total of 15 literatures,all of which were English literatures collected by Scientific Citation Index(SCI),and the NOS quality scores of all literatures were more than 7.According to the regional search of the SCI issue of the Chinese Academy of Sciences,there were 1 article in area 1,5 in area 2 and 9 in area 3.A total of 12473 cases of atypical meningioma were included in literatures.The results of Meta-analysis showed that postoperative adjuvant radiotherapy could prolong the overall survival(referred to OS)of patients with atypical meningioma(HR:0.71,95%CI:0.58-0.87,P=0.001).Another outcome index showed that postoperative adjuvant radiotherapy could prolong the progress free survival(referred to PFS)of patients(HR:0.67,95% CI: 0.51-0.89 P=0.006),but there was no significant correlation between postoperative adjuvant radiotherapy and recurrence(HR:0.85,95%CI:0.63~1.13,P=0.26).For patients with atypical meningioma who underwent gross total resection(referred to GTR),postoperative adjuvant radiotherapy could prolong the OS of patients(HR:0.61,95% CI:0.44 ~ 0.84).It shows that although the tumor is completely removed and postoperative adjuvant radiotherapy still plays a positive role,the result is still controversial.In the secondary outcome index,the OS of male patients with atypical meningioma was shorter than that of female patients with atypical meningioma(HR: 1.20,95% CI:1.02-1.42,P=0.03).Conclusions:As an adjuvant therapy for surgical treatment of atypical meningioma,postoperative adjuvant radiotherapy can prolong OS and PFS in patients with atypical meningioma,but there is no significant correlation between postoperative adjuvant radiotherapy and recurrence.Even after total resection,adjuvant radiotherapy plays an important role in prolonging the overall survival time of patients.However,this conclusion is still controversial at present,a large number of prospective studies are still needed to confirm the above conclusions and guide clinical treatment.