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在单一中心对接受放化疗和丙戊酸治疗的弥漫性脑桥内生型胶质瘤患儿的预后进行回顾性评估。

Retrospective evaluation of the outcomes of children with diffuse intrinsic pontine glioma treated with radiochemotherapy and valproic acid in a single center.

作者信息

Felix Francisco Helder Cavalcante, de Araujo Orlandira Leite, da Trindade Karine Martins, Trompieri Nadia Mendonça, Fontenele Juvenia Bezerra

机构信息

Pediatric Hemato-oncology Service, Pediatric Cancer Center, Hospital Infantil Albert Sabin, R Alberto Montezuma, 350 Vila Uniao, Fortaleza, CE, 60410-770, Brazil,

出版信息

J Neurooncol. 2014 Jan;116(2):261-6. doi: 10.1007/s11060-013-1280-6. Epub 2013 Nov 30.

Abstract

Diffuse intrinsic pontine glioma is a pediatric oncologic disease with dismal prognosis and no effective treatment. Since 2007, our patients have been using valproic acid as prophylactic anticonvulsant. We have undertaken a retrospective study in order to evaluate the influence of valproate in the outcomes of children with this disease in our center. Patients were treated with weekly carboplatin and vincristine and received conformal radiotherapy, either concurrent or sequential. Event-free survival and overall survival of patients not treated with valproic acid were 6.5 and 7.8 months. Accelerated failure time model (a parametric multivariate regression test for time-to-failure data) showed a statistically significant superiority of the median event-free survival of treated patients (6.5 vs. 9.5 months in treated patients; HR 0.54-95 % CI 0.33-0.87; p < 0.05) and also of overall survival (7.8 vs. 13.4 months in treated patients; HR 0.60-95 % CI 0.37-0.98; p = 0.05).

摘要

弥漫性脑桥内在型胶质瘤是一种预后不佳且无有效治疗方法的儿科肿瘤疾病。自2007年以来,我们的患者一直使用丙戊酸作为预防性抗惊厥药物。我们进行了一项回顾性研究,以评估丙戊酸盐对我们中心患有这种疾病的儿童治疗结果的影响。患者接受每周一次的卡铂和长春新碱治疗,并接受适形放疗,放疗方式为同步或序贯。未接受丙戊酸治疗的患者的无事件生存期和总生存期分别为6.5个月和7.8个月。加速失效时间模型(一种针对失效时间数据的参数化多变量回归测试)显示,接受治疗的患者的中位无事件生存期具有统计学意义上的显著优势(未治疗患者为6.5个月,治疗患者为9.5个月;风险比0.54 - 95%置信区间0.33 - 0.87;p < 0.05),总生存期也具有显著优势(未治疗患者为7.8个月,治疗患者为13.4个月;风险比0.60 - 95%置信区间0.37 - 0.98;p = 0.05)。

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