Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
J Neurooncol. 2012 Oct;110(1):99-104. doi: 10.1007/s11060-012-0939-8. Epub 2012 Jul 28.
To study the clinical characteristics, treatment approach and outcome of pleomorphic xanthoastrocytoma (PXA), patients were identified using the National Cancer Intitute's Surveillance, Epidemiology, and End Results (SEER) database. A total of 214 patients were identified with PXA using the November 2010 submission. Patient demographics, tumor characteristics, extent of surgical resection, the use of radiotherapy, and overall survival were evaluated. Overall survival for PXA was then compared to that of pilocytic astrocytoma, oligodendroglioma, ependymom and glioblastoma also using the SEER database. Kaplan-Meier, univariate and multivariate analyses were performed. The majority of patients were found to be young adults with the most common tumor location being temporal lobe. Surgery was performed on most (95 %) patients, while 25 % of patients received radiation therapy. Five and 10 year overall survival rates were 75 and 67 %, respectively. Grade was only available for a limited number of patients but appeared to affect prognosis. Patients with grade IV tumors had a median overall survival of 45 months, whereas median survival was not reached for grade I-III patients. On multivariate analysis, male gender and increasing age were associated with worse overall survival (p values 0.05 and <0.006, respectively). Extent of resection trended towards significance in favor of gross total resection. PXA is a rare diagnosis that affects young adults. Surgical resection is the primary modality of treatment with an overall good prognosis. Elderly patients, those with higher grade disease and patients with incomplete resections may have a worse prognosis. The role of radiation therapy for PXA remains unclear but is more often used for patients with high grade tumors. Compared to other common brain tumors, PXA's appear to fare worse than pilocytic astrocytoma and oligodendroglioma, especially in younger patients. However, even high grade PXA patients have significantly better overall survival compared to glioblastoma.
为了研究多形性黄色星形细胞瘤（PXA）的临床特征、治疗方法和结果，我们使用国家癌症研究所的监测、流行病学和最终结果（SEER）数据库来确定患者。共确定了 214 例 2010 年 11 月提交的 PXA 患者。评估了患者的人口统计学特征、肿瘤特征、手术切除程度、放疗的使用以及总生存率。然后，我们使用 SEER 数据库将 PXA 的总生存率与毛细胞星形细胞瘤、少突胶质细胞瘤、室管膜瘤和胶质母细胞瘤的总生存率进行了比较。进行了 Kaplan-Meier、单变量和多变量分析。大多数患者为年轻成年人，最常见的肿瘤部位是颞叶。大多数（95%）患者接受了手术，25%的患者接受了放疗。5 年和 10 年总生存率分别为 75%和 67%。由于分级仅在有限数量的患者中可用，因此似乎影响了预后。IV 级肿瘤患者的中位总生存期为 45 个月，而 I-III 级患者的中位生存期未达到。多变量分析显示，男性和年龄增长与总生存率较差相关（p 值分别为 0.05 和 <0.006）。切除程度向全切除趋势有利于总体生存率。PXA 是一种罕见的诊断，影响年轻成年人。手术切除是主要的治疗方式，总体预后良好。老年患者、高级别疾病患者和不完全切除的患者预后可能较差。放疗在 PXA 中的作用尚不清楚，但更多地用于高级别肿瘤患者。与其他常见的脑肿瘤相比，PXA 的预后似乎比毛细胞星形细胞瘤和少突胶质细胞瘤差，尤其是在年轻患者中。然而，即使是高级别 PXA 患者的总生存率也明显优于胶质母细胞瘤。
