역형성 뇌수막종 : 임상적 특징, 예후 인자 및 생존 결과에 대한 분석

다국어 초록 (Multilingual Abstract)

Abstract
Purpose
Anaplastic meningioma is very rare and is generally known to have a poor prognosis. However, due to its rarity, the relationship between clinical prognosis and prognostic factors is not clear. We analyzed the prognostic factors influencing survival outcomes of patients with anaplastic meningioma. Moreover, we analyzed on the progression pattern and the response to treatment about anaplastic meningioma.

Materials and Methods
Retrospective review of 48 patients with diagnosis of World Health Organization (WHO) grade 3 meningioma was performed. According to diagnosis type, primary anaplastic meningioma was included in 28 cases and secondary anaplastic meningioma in 20 cases. Gross total resection was performed in 36 patients (75%) and 32 patients (66.7%) received adjuvant radiotherapy after tumor resection with confirmed WHO grade 3 meningioma. Kaplan-Meier survival curve and Cox proportional hazards modeling were used for outcome analysis.

Results
Adjuvant radiotherapy was a robust prognostic factor for PFS and OS. Stereotactic radiosurgery confirmed the results expected to be effective in preventing local recurrence of tumors in the case of small size and higher radiation dose. In previous study, chemotherapy was known to have limit effect for anaplastic meningioma. There were patients who showed a partial effects.

Conclusion
Adjuvant radiotherapy is an essential treatment arm in patients with anaplastic meningiomas. Stereotactic radiosurgery seems to play an important role as a salvage treatment. But chemotherapy seems to have limited efficacy. Because of the disseminated nature of the disease, further investigations to improve survival outcome are needed.

목차 (Table of Contents)

• Contents
• Korean Abstract ·····················································································i
• List of Tables ······················································································iii
• List of Figures ·····················································································iv
• Introduction ·························································································1
• Methods ·····························································································2
• - Patient and Methods ········································································2
• - Statistical analysis ··········································································4
• Results ·······························································································4
• - Treatment summary ········································································4
• - Analysis of survival ········································································5
• - Progression pattern and salvage treatment·············································5
• - Response to salvage treatment ··························································6
• Discussion ··························································································7
• Conclusion ··························································································9
• Reference ··························································································10
• Abstract ····························································································21