Department of Neurological Surgery, University of California, San Francisco, California 94117, USA.
J Clin Neurosci. 2011 Jun;18(6):750-4. doi: 10.1016/j.jocn.2010.11.007. Epub 2011 Apr 19.
Astroblastoma is a rare tumor, and thus experience with these lesions is very limited. The prognosis and appropriate treatment is not well understood, as few individual centers have enough experience with astroblastoma to guide treatment recommendations. We performed a systematic comprehensive search of the published English language literature on patients undergoing surgery for astroblastoma to summarize what is known about these tumors, and to provide some framework for future efforts in this area. A total of 62 references met our inclusion criteria, and contained individual patient data on 116 patients with astroblastoma. Determination of overall survival rates was performed using Kaplan-Meier analysis. This analysis suggests that the distribution is bimodal, with a prominent peak in young adulthood. Astroblastomas are generally amenable to complete tumor resection, even when very large, with gross total resection (GTR) achieved in 71/85 (84%) of reported patients, including both 9cm tumors reported. Patients undergoing GTR experienced a significant improvement in survival compared to patients who underwent subtotal resection (STR) (5-year progression-free survival: GTR 83% versus [vs.] STR 55%, log rank p=0.011). Although patients receiving external beam radiotherapy or fractionated three-dimensional conformal radiotherapy (XRT) seemed to have lower survival rates, this was not statistically significant (5-year survival: GTR 94% vs. GTR+XRT 73%, log rank p=0.463). Thus, we have reported the results of a summary of the literature on astroblastomas and have accurately described outcome characteristics using a data set that would be difficult to accumulate at a single center treating this tumor.
神经节细胞瘤是一种罕见的肿瘤，因此对这些病变的经验非常有限。由于很少有个别中心有足够的神经节细胞瘤经验来指导治疗建议，因此对其预后和适当的治疗方法了解甚少。我们对发表的英文文献进行了系统全面的搜索，以了解接受神经节细胞瘤手术治疗的患者的情况，总结了对这些肿瘤的了解，并为该领域的未来研究提供了一些框架。共有 62 篇参考文献符合我们的纳入标准，其中包含 116 例神经节细胞瘤患者的个体患者数据。使用 Kaplan-Meier 分析确定总生存率。该分析表明，分布呈双峰型，在青年期有一个明显的高峰。神经节细胞瘤通常可以通过完全肿瘤切除术来治疗，即使肿瘤非常大，在报告的 85 例患者中有 71 例（84%）实现了大体全切除（GTR），包括报告的 9cm 肿瘤。与接受次全切除术（STR）的患者相比，接受 GTR 的患者的生存情况有显著改善（5 年无进展生存率：GTR 为 83%，STR 为 55%，对数秩检验 p=0.011）。尽管接受外照射或分次三维适形放疗（XRT）的患者的生存率似乎较低，但这没有统计学意义（5 年生存率：GTR 为 94%，GTR+XRT 为 73%，对数秩检验 p=0.463）。因此，我们报告了对神经节细胞瘤文献综述的结果，并使用在单一中心治疗这种肿瘤难以积累的数据准确描述了预后特征。
