Stupp Roger, Reni Michele, Gatta Gemma, Mazza Elena, Vecht Charles
University Hospital (CHUV), Lausanne, Switzerland.
Crit Rev Oncol Hematol. 2007 Jul;63(1):72-80. doi: 10.1016/j.critrevonc.2007.03.003. Epub 2007 May 2.
Anaplastic astrocytoma is an uncommon disease in the adult population. Prognosis is influenced by age, symptom duration, mental status and Karnofsky performance status. A truly complete resection, which is a recognized independent prognostic factor, is not possible and recurrence in the surgical cavity is common. Based on randomized data available, chemotherapy has consistently failed to improve the outcome of patients with anaplastic astrocytoma, while a meta-analysis showed a small, but significant improvement in survival favouring the use of chemotherapy. Outside a clinical trial, postoperative radiotherapy (30 x 2 Gy) remains the standard adjuvant therapy for most patients. For elderly patients, the application of treatment is usually based on performance status and neurological function. In recurrent disease, chemotherapy with temozolomide has been proven to be active and well-tolerated in phase II trials, but no comparative phase III trials of other cytotoxic drugs have been conducted.
间变性星形细胞瘤在成人中是一种罕见疾病。预后受年龄、症状持续时间、精神状态和卡氏功能状态影响。真正的完全切除是公认的独立预后因素，但无法实现，手术腔复发很常见。基于现有随机数据，化疗一直未能改善间变性星形细胞瘤患者的预后，而一项荟萃分析显示，化疗虽有小幅但显著的生存改善。在临床试验之外，术后放疗（30×2Gy）仍是大多数患者的标准辅助治疗。对于老年患者，治疗应用通常基于功能状态和神经功能。在复发性疾病中，替莫唑胺化疗在II期试验中已被证明有效且耐受性良好，但尚未进行其他细胞毒性药物的对比III期试验。
