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幕上大体全切除非间变室管膜瘤:基于人群的治疗模式和结局分析。

Supratentorial gross-totally resected non-anaplastic ependymoma: population based patterns of care and outcomes analysis.

机构信息

Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd. Unit 0097, Houston, TX, 77030, USA,

出版信息

J Neurooncol. 2013 Dec;115(3):513-20. doi: 10.1007/s11060-013-1254-8. Epub 2013 Oct 2.

Abstract

Observation following gross-total resection (GTR) for non-anaplastic supratentorial ependymomas is often advocated based on small, retrospective series. The purpose of this study is to perform a population-based analysis to examine outcomes for this rare cohort of low-risk patients. A retrospective analysis was conducted utilizing the Surveillance, Epidemiology and End Results Program of the United States National Cancer Institute. We identified patients with supratentorial non-anaplastic ependymoma who underwent GTR alone or GTR followed by radiation. We identified 92 patients who met these criteria. The median age was 17.5 years (range 1-83) with the majority female (58 %) and white (75 %). Radiotherapy (RT) was delivered in half of patients. The 5-/10-year Kaplan-Meier estimated overall survival (OS) and cause-specific survival (CSS) for the overall cohort was 83.2/71.4 and 84.1/78.0 %, respectively. There was no evidence of decreased CSS (HR 0.52 [0.18-1.51]; p = 0.23) or OS (HR 0.63 [0.25-1.59]; p = 0.33) with the omission of RT on univariate analysis. Age ≥18 years correlated with worse OS (HR 4.01 [1.45-11.11]; p = 0.008) and CSS (HR 2.86 [0.99-8.31]; p = 0.05). RT did not impact outcome for this low-risk cohort of patients. Older age correlates with poor prognosis.

摘要

非间变幕上室管膜瘤行大体全切除(GTR)后的观察常基于小样本回顾性系列研究。本研究旨在进行一项基于人群的分析,以检查这一低危患者罕见队列的结果。我们利用美国国家癌症研究所的监测、流行病学和最终结果计划进行了回顾性分析。我们确定了仅行 GTR 或 GTR 后行放疗的幕上非间变室管膜瘤患者。我们确定了 92 名符合这些标准的患者。中位年龄为 17.5 岁(范围 1-83 岁),大多数为女性(58%)和白人(75%)。半数患者接受了放疗。全队列的 5 年和 10 年 Kaplan-Meier 估计总生存率(OS)和疾病特异性生存率(CSS)分别为 83.2%/71.4%和 84.1%/78.0%。单因素分析显示,未行放疗并未导致 CSS(HR 0.52 [0.18-1.51];p=0.23)或 OS(HR 0.63 [0.25-1.59];p=0.33)降低。年龄≥18 岁与 OS(HR 4.01 [1.45-11.11];p=0.008)和 CSS(HR 2.86 [0.99-8.31];p=0.05)较差相关。对于这一低危患者队列,放疗并未影响预后。年龄较大与预后不良相关。

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