间变性星形细胞瘤患者的五年随访结果及替莫唑胺同步治疗复发性间变性星形细胞瘤的疗效

Five-year follow-up results for patients diagnosed with anaplastic astrocytoma and effectiveness of concomitant therapy with temozolomide for recurrent anaplastic astrocytoma.

作者信息

Sarica Feyzi Birol, Cekinmez Melih, Tufan Kadir, Sen Orhan, Onal Huseyin C, Mertsoylu Huseyin, Topkan Erkan, Pehlivan Berrin, Erdogan Bulent, Altinors Mehmet N

机构信息

Department of Neurosurgery, Baskent University Faculty of Medicine, Ankara, Turkey.

出版信息

Asian J Neurosurg. 2012 Oct;7(4):181-90. doi: 10.4103/1793-5482.106650.

BACKGROUND

Anaplastic astrocytoma (AA; WHO grade-III) patients determination of prognostic factors helps generating multimodal therapy protocols. For this purpose, in the Baskent University, Adana Medical Research Center, specific characteristics of AA patients who have surgery were retrospectively investigated and factors which affect prognosis has been determined.

PATIENTS AND METHODS

Between January 2005 and 2009, 20 patients who have AA have been evaluated retrospectively. Totally, 20 patients had 31 operations. Sixteen patients had only adjuvant radiation therapy (RT). In the postoperative period, 8 patients received adjuvant RT. Nine of 10 patients with tumor recurrence received concomitant therapy with temozolomide (ConcT with TMZ) protocol. No adjuvant therapy protocol could be applied in three patients with poor general condition in the postoperative period.

RESULTS

Median survival for patients died was 16±17 months; one year survival was 75% and five year survival 25%. After univariate analysis, preoperative Karnofsky performance score (KPS) was ≥80 (P=0.005577()), postoperative KPS was ≥80 (P=0.003825()), type of tumor resection (P=0.001751()), multiple operations (P=0.006233()), and ConcT with TMZ protocol (P=0,005766(*)) were all positive prognostic factors which extend the survival.

CONCLUSIONS

The results of the multivariate analysis did not put forward an independent prognostic factor acting on the survival period (P>0.05).

背景

间变性星形细胞瘤（AA；世界卫生组织III级）患者预后因素的确定有助于制定多模式治疗方案。为此，在巴斯肯大学阿达纳医学研究中心，对接受手术的AA患者的具体特征进行了回顾性研究，并确定了影响预后的因素。

患者与方法

回顾性评估了2005年1月至2009年期间20例患有AA的患者。总共20例患者接受了31次手术。16例患者仅接受辅助放疗（RT）。术后，8例患者接受了辅助放疗。10例肿瘤复发患者中有9例接受了替莫唑胺联合治疗方案（替莫唑胺联合治疗）。3例术后全身状况较差的患者无法应用辅助治疗方案。

结果

死亡患者的中位生存期为16±17个月；一年生存率为75%，五年生存率为25%。单因素分析后，术前卡诺夫斯基表现评分（KPS）≥80（P=0.005577（））、术后KPS≥80（P=0.003825（））、肿瘤切除类型（P=0.001751（））、多次手术（P=0.006233（））和替莫唑胺联合治疗方案（P=0.005766（*））均为延长生存期的阳性预后因素。