10053-mng-1 利用脑室上脑膜瘤的风险因素对肿瘤体积增长率进行分层

Ryuichi Hirayama, Shuhei Yamada, Takamitsu Iwata, Yuki Kawamoto, Kanji Nakagawa, Kouki Murakami, R. Utsugi, T. Tachi, Hideki Kuroda, Noriyuki Kijima, Y. Okita, Naoki Kagawa, H. Kishima
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METHODS 313 cases were included in the study, with the origin of meningioma being the circumflex and parasagittal sinus areas and the cerebral sickle region, and with multiple MRI scans performed at intervals of at least 3 months. Relative growth rate (RGR) and annual volume change (AVC) were calculated by tumor volume, and the patients were classified into three groups according to the combination of gender, age, and MRI T2WI signal intensity, and compared. RESULTS The median RGR and AVC of the entire cohort were 6.1% and 0.20 cm3/year, respectively, and there were significant differences between groups in gender (p=0.018) and MRI T2WI (p < 0.001) for RGR and tumor location (p=0.025) and initial tumor volume (p < 0.001)for AVC. 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摘要

背景脑膜瘤的自然史尚不清楚,也没有基于治疗干预必要性和时机的客观指标制定指南。目的:通过统计肿瘤体积变化的特征,对肿瘤生长的危险因素进行分层,并在此基础上生成预测肿瘤体积曲线,以描述脑膜瘤的自然历史。方法313例脑膜瘤起源于旋矢状窦区、旁矢状窦区和脑镰状区,每隔至少3个月进行多次MRI扫描。以肿瘤体积计算肿瘤相对生长率(Relative growth rate, RGR)和年体积变化(annual volume change, AVC),并结合性别、年龄、MRI T2WI信号强度将患者分为三组进行比较。结果整个队列的中位RGR和AVC分别为6.1%和0.20 cm3/年,组间RGR、肿瘤位置(p=0.025)和AVC的初始肿瘤体积(p < 0.001)在性别(p=0.018)、MRI T2WI (p < 0.001)上存在显著差异。超高速组RGR和AVC的中位数分别为17.5%和1.05 cm3/年,高速组为8.2%和0.33 cm3/年,低速组为3.4%和0.04 cm3/年,组间差异有统计学意义(p < 0.001)。预测肿瘤体积曲线显示,在5年内,超高速生长组的肿瘤体积平均增加2.24倍或5.24 cm3,而低生长组的肿瘤体积变化很小。结论肿瘤生长危险因素的组合可以对肿瘤生长进行分层,并为各县提供预测肿瘤体积曲线。结果可能有助于幕上脑膜瘤的治疗。
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10053-MNG-1 STRATIFICATION OF TUMOR VOLUME GROWTH RATE USING RISK FACTORS IN SUPRATENTORIAL MENINGIOMAS
Abstract BACKGROUND The natural history of meningiomas is still unclear, and no guidelines have been established based on objective indices regarding the necessity and timing of therapeutic intervention. Objective: We attempted to provide statistics on the characteristics of tumor volume change, stratify tumor growth by risk factors, and generate a predictive tumor volume curve based on the statistics, with the aim of describing the natural history of meningiomas. METHODS 313 cases were included in the study, with the origin of meningioma being the circumflex and parasagittal sinus areas and the cerebral sickle region, and with multiple MRI scans performed at intervals of at least 3 months. Relative growth rate (RGR) and annual volume change (AVC) were calculated by tumor volume, and the patients were classified into three groups according to the combination of gender, age, and MRI T2WI signal intensity, and compared. RESULTS The median RGR and AVC of the entire cohort were 6.1% and 0.20 cm3/year, respectively, and there were significant differences between groups in gender (p=0.018) and MRI T2WI (p < 0.001) for RGR and tumor location (p=0.025) and initial tumor volume (p < 0.001)for AVC. The median RGR and AVC in the classification were 17.5% and 1.05 cm3/year for the very high growth group, 8.2% and 0.33 cm3/year for the high growth group, and 3.4% and 0.04 cm3/year for the low growth group, showing significant differences between the groups (p < 0.001). The predicted tumor volume curve showed an average 2.24-fold or 5.24 cm3 increase in volume over 5 years in the very high-growth group, while little tumor volume change was observed in the low-growth group. CONCLUSION The combination of growth risk factors allowed stratification of tumor growth and provided a predictive tumor volume curve for each county. The results may assist in the treatment of supratentorial meningiomas.
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