Meta-analysis Of The Efficacy Of Postoperative Radiotherapy For Atypical Meningiomas

Objective: To systematically assess the value of adjuvant radiotherapy in the treatment of patients with atypical meningiomas after total resection.Method: The Cochrane Library,PubMed,and EMBASE databases were searched from inception to March 2021 to identify reports involving adjuvant radiotherapy for patients with atypical meningiomas after total resection.The primary outcome was progression-free survival(PFS)and the secondary outcome was overall survival(OS);the related risk ratios(HR)and 95% confidence intervals(CI)were extracted.Revman 5.4 software was used for the meta-analysis and publication bias was evaluated.Results: Finally,10 articles were included involving 6,259 patients,of which 1,399 patients(22.35%;treatment group)had undergone adjuvant radiotherapy after total resection,accounting for 22.35% of the total and 4.860 patients(77.65%;control group)had undergone only total resection but not adjuvant radiotherapy.PFS and OS were used as prognostic indicators.The results revealed that:(1)the PFS of patients with total resection of atypical meningiomas was improved by adjuvant radiotherapy,but there was no significant difference between the two groups(HR = 0.63,95% CI = 0.32–1.23,P = 0.17),and(2)adjuvant radiotherapy tended to improve the OS of patients with total resection of atypical meningiomas,but there was no significant difference between the two groups(HR = 0.86,95% CI = 0.70–1.05,P = 0.14).Conclusion: Considering the adverse effects and economic burden of radiotherapy on patients,combined with the results of this meta-analysis,the treatment of patients with atypical meningioma should be aimed at achieving total resection.For patients in whom total tumor resection has been achieved,strict follow-up rather than early postoperative adjuvant radiotherapy can be considered.