| Meningiomas were mesoblast by origin, the majority of meningiomas are histologically benign tumors, however, despite aggressive surgery and irradiation, it is easy to recurrence postoperatively, the 5-year recurrence rate of meningiomas was 10%~20%. In addition, there is an increased risk of malignancy for recurrence meningiomas. Currently, Surgery remains the mainstay of meningioma management when technically possible and associated with an acceptable risk, radiation therapy and chemotherapy are adjuvant therapies. However, Location and invasion of tumour tissue in adjacent structures may hamper radical resections and give rise to recurrences. Surgical excision of recurrent tumors was difficult and with significant morbidity and mortality rates, moreover, recurrent tumors were unsensitive to traditional radiation therapy. Stereotactic radiation therapy was too expensive for these recurrent tumors and with a properlimit in volume of tumors. In addition, big-dosage and multiple-drug associated chemotherapy wasn't fit to long-term treatment due to severe side effects and poor result. It's still a problem for clinicians to prevent the recurrence of meningiomas and management of recurrent or unresectable meningiomas.ObjectiveThe clinical trial was supposed to explore an effective adjuvant management of postoperative meningiomas. Chemotherapy is being explored as another potential treatment option for unresectable or recurrent meningiomas. Hydroxyurea is a suitable chemotherapeutic agent that inhibits ribonucleotide reductase, hampering the growth of meningioma cells effectively, decreasing the size of meningiomas and preventing the recurrence of tumors with an accepted toxicity effects. Long-term hydroxyurea treatment was well tolerated, economical, safe, and accepted by most patientsMaterials and Methods35 selected patients were treated with hydroxyurea. The patients were divided into two groups: meningioma-treatment group and prevent-recurrence group. Meningioma-treatment group consist of 15 patient, including unresectable, residual or recurrent non-operative meningiomas; prevent-recurrence group, 17 patients, All them accepted an craniotomy to removal of meningioma totally, including meningiomas with the abnormal of the distribution of DNA ploidy checked by flowcytometer or with high level proliferative index. All the patients of two groupsaccepted long-term hydroxyurea treatment after CBC checkups were performed at postoperative two weeks. All patients received hydroxyurea at a dosage level of 1000 to 1500 mg/day (approximately 20 mg/kg/day). During the treatment period, clinical manifestations were observed closely and scheduled CBC, scheduled head CT or scheduled brain MRI were performed. All the data should be analysised with software SPSS.ResultsIn all elective patients , 3 patients required dosage reductions due to hematological toxicity, their peripheral WBC count was found less than 2.5xl03/ul when hydroxyurea was administrated ed by oral a week later, the dosage of hydroxyurea was reduced to lOmg/kg/day.One week later , there were some rises in their peripheral WBC count in a certain degree, however, the dosage of hydroxyurea was forced to maintain lOmg/kg/day because WBC count was falling again when hydroxyurea was administrated at a dosage of 20mg/kg/day.In the others, there were several patients companied with peripheral WBC count waving during the treatment period (WBO2.5X 103 / pi) ,no special treatments were given and peripheral WBC count stopped to falling. During the follow up period, no patient was forced to cease the treatment due to the peripheral WBC count falling. Serial MR images or head CT were obtained monthly in order to observe the condition and variety of intracranial meningiomas during the period hydroxyurea was administered, whether the meningioma recurrence should be paid attention to and the sizes of tumors should be measured carefully. 15 patients of prevent-recurrence group haven't any evidence of meningiomasrecurrence in 6 months t...
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