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星型细胞瘤:基于监测、流行病学和最终结果(SEER)的治疗模式分析。

Astroblastomas: a Surveillance, Epidemiology, and End Results (SEER)-based patterns of care analysis.

机构信息

Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.

Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.

出版信息

World Neurosurg. 2014 Jul-Aug;82(1-2):e291-7. doi: 10.1016/j.wneu.2013.10.035. Epub 2013 Oct 16.

Abstract

OBJECTIVE

This study sought to report patient characteristics, risk factors, and trends in management for astroblastoma patients.

METHODS

A retrospective analysis was conducted utilizing the Surveillance, Epidemiology and End Results Program of the National Cancer Institute.

RESULTS

Two hundred and thirty-nine patients were identified, with 206 patients receiving treatment. The median age at diagnosis was 35 years (range 0 to 84 years). Tumor location was available for 177 patients, and the majority were supratentorial (n = 144, 81.3%). The median overall survival and cause-specific survival for the cohort receiving treatment was 55 and 65 months, respectively. On univariate analysis, patients receiving surgery alone compared to only radiotherapy displayed improved overall survival (OS) and cause-specific survival (CSS) with a 5-year OS of 62.2% vs. 27.3%, P < .001, and CSS of 67.3% vs. 31.9%, P = .003. Supratentorial tumor location was associated with worse survival, with an estimated 5-year OS of 44.9% for supratentorial tumors compared to 75% for infratentorial tumors (hazard ratio 3.41 [95% CI, 1.76 to 6.62]; P < .001) and CSS of 47.5% (supratentorial) to 82% (infratentorial) (hazard ratio 3.95 [95% CI, 1.81 to 8.62]; P = .001). Age >60 years at diagnosis and treatment before 1990 were correlated with decreased survival on both the univariate and the multivariate analyses.

CONCLUSIONS

To our knowledge, this is the largest report of astroblastoma patients described in the literature. Supratentorial tumor location, older age, and treatment prior to 1990 were poor prognostic factors.

摘要

目的

本研究旨在报告星形母细胞瘤患者的特征、风险因素和治疗趋势。

方法

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回顾性分析。

结果

共确定了 239 名患者,其中 206 名患者接受了治疗。诊断时的中位年龄为 35 岁(0 至 84 岁)。177 名患者的肿瘤位置可查,大多数位于幕上(n = 144,81.3%)。接受治疗的队列的中位总生存期和特异性生存期分别为 55 个月和 65 个月。单因素分析显示,与仅接受放疗相比,仅接受手术的患者的总生存期(OS)和特异性生存期(CSS)得到改善,5 年 OS 分别为 62.2%和 27.3%,P<0.001,CSS 分别为 67.3%和 31.9%,P=0.003。幕上肿瘤位置与生存较差相关,幕上肿瘤的估计 5 年 OS 为 44.9%,而幕下肿瘤为 75%(风险比 3.41[95%可信区间,1.76 至 6.62];P<0.001),CSS 为 47.5%(幕上)至 82%(幕下)(风险比 3.95[95%可信区间,1.81 至 8.62];P=0.001)。诊断时年龄>60 岁和 1990 年前的治疗与单因素和多因素分析中的生存下降相关。

结论

据我们所知,这是文献中报道的最大星形母细胞瘤患者报告。幕上肿瘤位置、年龄较大和 1990 年前的治疗是预后不良的因素。

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