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Article Dans Une Revue Journal of Neuro-Oncology Année : 2021

Multimodal management of surgery- and radiation-refractory meningiomas: an analysis of the French national tumor board meeting on meningiomas cohort

Thomas Graillon
Mathieu Boone
  • Fonction : Auteur
  • PersonId : 1149851
  • IdRef : 157767957
François Caire
  • Fonction : Auteur
François Ducray
Aymeri Huchet
  • Fonction : Auteur
Ilyess Zemmoura
  • Fonction : Auteur
  • PersonId : 1098036
O. Chinot
Marc Sanson
Michel Kalamarides
Matthieu Peyre
  • Fonction : Auteur correspondant

Résumé

PURPOSE: Meningiomas represent the most frequent tumor of the central nervous system in adults. While most meningiomas are efficiently treated by surgery and radiotherapy/radiosurgery, there is a small portion of radiation- and surgery-refractory tumors for which there is no clear recommendation for optimal management. The French National Tumor Board Meeting on Meningiomas (NTBM) offers a glimpse on the current management of such patients. METHODS: We retrospectively reviewed the charts of patients presented to the multidisciplinary Meeting between 2016 and 2019. We selected patients with a progressive disease after at least two treatments, including surgery and radiotherapy. RESULTS: In this multicentric cohort of 86 cases, patients harbored 17 (19.8%) WHO Grade I, 48 (55.8%) WHO Grade II and 21 (24.4%) WHO Grade III tumors. The median number of treatments received before inclusion was 3 (range: 2 - 11). Following the Board Meeting, 32 patients (37.2%) received chemotherapy, 11 (12.8%) surgery, 17 (19.8%) radiotherapy, 14 (16.3%) watchful observation and 12 (13.9%) palliative care. After a mean follow-up of 13 months post-inclusion, 32 patients (37.2%) had died from their disease. The mean progression free survival was 27 months after radiotherapy, 10 months after surgery, 8.5 months after chemotherapy (Bevacizumab: 9 months - Octreotide/Everolimus: 8 months). CONCLUSIONS: Surgery- and radiation-refractory meningiomas represent a heterogeneous group of tumors with a majority of WHO Grade II cases. If re-irradiation and redo-surgery are not possible, bevacizumab and octreotide-everolimus appear as a valuable option in heavily pre-treated patients considering the current EANO guidelines.
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Dates et versions

hal-03194557 , version 1 (09-04-2021)

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Tuan Le Van, Thomas Graillon, Julian Jacob, Elodie Vauleon, Loic Feuvret, et al.. Multimodal management of surgery- and radiation-refractory meningiomas: an analysis of the French national tumor board meeting on meningiomas cohort. Journal of Neuro-Oncology, 2021, 153 (1), pp.55-64. ⟨10.1007/s11060-021-03741-7⟩. ⟨hal-03194557⟩
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