Stellenwert der Strahlentherapie bei der Behandlung des meningealen Melanozytoms

TY - JOUR

T1 - Stellenwert der Strahlentherapie bei der Behandlung des meningealen Melanozytoms

AU - Rades, Dirk

AU - Tatagiba, Marcos

AU - Brandis, Almuth

AU - Dubben, Hans-Hermann

AU - Karstens, Johann Hinrich

PY - 2002/6/1

Y1 - 2002/6/1

N2 - BACKGROUND: Meningeal melanocytoma is described as rare benign lesion with a high risk of recurrence. There are no well-substantiated treatment recommendations in the literature. Only case reports have been published by now.PATIENTS AND METHODS: In 1997 a patient was irradiated for a recurrent spinal meningeal melanocytoma and 2 years later for brain metastases indicating malignant transformation. This case gave rise to a literature review for therapeutic options. All sufficiently documented cases published since 1972, when the term meningeal melanocytoma was established, were evaluated. Based on published and on original data recurrence and overall survival rates up to 5 years were calculated for three different therapeutic approaches, namely complete tumor resection, incomplete resection with subsequent radiotherapy, and incomplete resection alone. Statistical evaluation was performed using the chi 2 test and Kaplan-Meier-analysis.RESULTS: 53 patients (including our patient) met selection criteria. Complete tumor resection was superior to incomplete resection alone with lower recurrence (4-38% versus 50-92%) and better overall survival rates (86-95% versus 30-58%). After incomplete resection radiotherapy seemed to improve prognosis (recurrence 15-45%; overall survival 91-92%). Between complete resection and incomplete resection plus radiotherapy no significant differences were observed.CONCLUSIONS: For meningeal melanocytoma complete resection must be regarded as the best of the modalities compared. After incomplete resection radiotherapy should be considered, although a specific radiotherapeutic regimen cannot be recommended at present. However, for multiple cranial or spinal lesions total cranial irradiation or craniospinal irradiation is indicated.

AB - BACKGROUND: Meningeal melanocytoma is described as rare benign lesion with a high risk of recurrence. There are no well-substantiated treatment recommendations in the literature. Only case reports have been published by now.PATIENTS AND METHODS: In 1997 a patient was irradiated for a recurrent spinal meningeal melanocytoma and 2 years later for brain metastases indicating malignant transformation. This case gave rise to a literature review for therapeutic options. All sufficiently documented cases published since 1972, when the term meningeal melanocytoma was established, were evaluated. Based on published and on original data recurrence and overall survival rates up to 5 years were calculated for three different therapeutic approaches, namely complete tumor resection, incomplete resection with subsequent radiotherapy, and incomplete resection alone. Statistical evaluation was performed using the chi 2 test and Kaplan-Meier-analysis.RESULTS: 53 patients (including our patient) met selection criteria. Complete tumor resection was superior to incomplete resection alone with lower recurrence (4-38% versus 50-92%) and better overall survival rates (86-95% versus 30-58%). After incomplete resection radiotherapy seemed to improve prognosis (recurrence 15-45%; overall survival 91-92%). Between complete resection and incomplete resection plus radiotherapy no significant differences were observed.CONCLUSIONS: For meningeal melanocytoma complete resection must be regarded as the best of the modalities compared. After incomplete resection radiotherapy should be considered, although a specific radiotherapeutic regimen cannot be recommended at present. However, for multiple cranial or spinal lesions total cranial irradiation or craniospinal irradiation is indicated.

KW - Adolescent

KW - Adult

KW - Aged

KW - Cranial Irradiation

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Melanoma

KW - Meningeal Neoplasms

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Neoplasm, Residual

KW - Nevus

KW - Prognosis

KW - Radiotherapy, Adjuvant

KW - Survival Rate

M3 - SCORING: Zeitschriftenaufsatz

C2 - 12122790

VL - 178

SP - 336

EP - 342

JO - STRAHLENTHER ONKOL

JF - STRAHLENTHER ONKOL

SN - 0179-7158

IS - 6

ER -