Einfluss regionaler Radonkonzentration auf Meningeompatienten: Ergebnisse einer zehnjährigen monozentrischen retrospektiven Studie

Radon-222 exposure has been implicated in the development of various malignancies, including central nervous system tumors. This study investigates the potential relationship between regional residential radon conventration (RRC) and the clinical and pathological characteristics of meningioma (MNG).

A retrospective analysis was conducted of 4435 patient files, identifying 1025 cases of histologically confirmed meningiomas treated with partial or total resection between January 2012 and December 2022. Demographic data, histological subtypes, tumor location, tumor characteristics, survival outcome, and RRC data (obtained from the Geoportal of the Federal Office for Radiation Protection) were analyzed. Patients were stratified into four groups based on RRC levels: Group 1 (0–50 kBq/m³; n=179), Group 2 (51–100 kBq/m³; n=537), Group 3 (101–150 kBq/m³; n=202), and Group 4 (>151 kBq/m³; n=107). Statistical analyses included the Pearson chi-square test, Kruskal-Wallis test, and Kaplan-Meier survival analysis.

The median age of the cohort was 66.7 years (standard deviation (SD) 13.6 years, range 14.7-95 years), with a female predominance (73.6%; female ratio of 3:1). Gender and age were evenly distributed across all RRC groups (p=0.908 and p=0.969, respectively). The mean age across all groups ranged from 62.1 to 62.8 years, having no significant difference among the RRC groups (p=0.978). Meningothelial MNG WHO-Grad 1 was the most common histological subtype (n=428), with 53% of cases in group 2. Tumor were most frequently located at the convexity (58% of all cases), with group 2 also comprising the highest proportion (n=309). Skull base MNGs accounted for 332 cases, with 54.5% occurring in group 2 (p=0.767). Kaplan-Meier analysis revealed no statistical significant association between RRC and overall survival (p=0.651).

This study found no significant impact of residential radon exposure on the clinical characteristics or overall survival of MNG patients. Limitations include the use of averaged radon concentrations with a spatial resolution of 1 square kilometer, without direct measurements in patients' homes and unknown residence duration. Future studies should incorporate direct household measurements and residence duration to better understand the relationship between radon exposure and meningioma characteristics. Whether there is a correlation between MNG recurrence and MNG size with radon exposure is yet to be determined.