Rosenthal Mark A, Drummond Katharine J, Dally Michael, Murphy Michael, Cher Lawrence, Ashley David, Thursfield Vicky, Giles Graham G
Royal Melbourne Hospital, Parkville, VIC.
Med J Aust. 2006 Mar 20;184(6):270-3. doi: 10.5694/j.1326-5377.2006.tb00235.x.
To describe the management of and outcomes in a population-based cohort of patients with newly diagnosed glioma.
DESIGN, SETTING AND PATIENTS: Retrospective cohort study of patients with glioma newly diagnosed over the period 1998-2000 in Victoria. Patients were identified from the population-based Victorian Cancer Registry (VCR). Doctors involved in managing the patients were surveyed by a questionnaire sent out in 2003. The cohort was followed until the end of 2004 to obtain at least 4 years' follow-up data on all patients.
Reported treatment, referral patterns and survival rates.
Over the study period, 992 cases of glioma were identified; 828 completed surveys on eligible patients were obtained (response rate, 93%); 473 patients (57%) had glioblastoma multiforme (GBM); 105 patients (13%) diagnosed with "glioma" had had no histological confirmation. Complete macroscopic resection was performed in 209 patients (25%); 612 patients (74%) were referred for radiotherapy and 326 (54%) for chemotherapy; 39 (5%) were enrolled on a clinical trial. Median survival was 9.2 months for all patients and 7.4 months for patients with GBM.
This is the largest reported glioma management survey in the world to date. Much of the patient demographics and approach to treatment were as expected and represent a reasonable "standard of care". However, there are some areas for improvement, including the absence of histological diagnosis in some patients, lack of multidisciplinary care, low clinical trial enrollment and poor use of ancillary services.
描述以人群为基础的新诊断神经胶质瘤患者队列的管理情况及治疗结果。
设计、研究地点与患者：对1998 - 2000年期间在维多利亚州新诊断的神经胶质瘤患者进行回顾性队列研究。通过基于人群的维多利亚癌症登记处（VCR）识别患者。2003年通过问卷调查对参与患者管理的医生进行了调查。对该队列进行随访直至2004年底，以获取所有患者至少4年的随访数据。
报告的治疗情况、转诊模式和生存率。
在研究期间，共识别出992例神经胶质瘤病例；获得了828例符合条件患者的完整调查问卷（应答率为93%）；473例患者（57%）患有多形性胶质母细胞瘤（GBM）；105例诊断为“神经胶质瘤”的患者未进行组织学确诊。209例患者（25%）进行了完整的肉眼切除；612例患者（74%）被转诊接受放疗，326例患者（54%）接受化疗；39例患者（5%）参加了临床试验。所有患者的中位生存期为9.2个月，GBM患者为7.4个月。
这是迄今为止世界上报道的最大规模的神经胶质瘤管理调查。大部分患者人口统计学特征和治疗方法符合预期，代表了合理的“护理标准”。然而，仍有一些方面需要改进，包括部分患者缺乏组织学诊断、缺乏多学科护理、临床试验入组率低以及辅助服务利用不足。
