Adeberg Sebastian, Bostel Tilman, König Laila, Welzel Thomas, Debus Juergen, Combs Stephanie E
Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Radiat Oncol. 2014 Apr 23;9:95. doi: 10.1186/1748-717X-9-95.
Long-term survival is rare in patients with glioblastoma (GBM). We set out to determine prognostic factors for patients with favorable and poor prognosis in regard of tumor localization to the subventricular zone (SZV).
We reviewed the clinical records, pre-operative and post-operative MRI imaging of 50 LTS long-term survivors (LTS) (> 3 years) and 50 short-term survivors (STS) (< 1 year) with glioblastoma. These groups were matched for clinical characteristics being consistently associated with prolonged or shortened survival. All patients had undergone initial surgery or biopsy to confirm GBM diagnosis followed by radio- or chemoradiotherapy.
LTS had a median progression-free survival PFS of 25, 4 months (2, 3-97, 8 months) and overall-survival (OS) of 55, 9 months (38, 2-98, 6 months) compared to STS who had a significantly lower PFS of 4, 2 months (1, 4-10, 2 months) and OS of 6, 6 months (2, 2-11, 6 months) (each p < 0,001).Survival analysis showed that age under 60 years (p < 0,001), total resection status (p < 0,001) and tumor localization without SVZ contact (p = 0,05) were significant factors for prolonged survival.
Our findings underline that survival in GBM patients is heterogeneous and influenced by multiple factors. This study confirms that tumor location with regard to the SVZ is significantly associated with survival.
胶质母细胞瘤(GBM)患者的长期生存极为罕见。我们着手确定在肿瘤位于脑室下区(SZV)方面预后良好和预后不良患者的预后因素。
我们回顾了50例胶质母细胞瘤长期幸存者(LTS,>3年)和50例短期幸存者(STS,<1年)的临床记录、术前和术后MRI影像。这些组在与生存延长或缩短始终相关的临床特征方面进行了匹配。所有患者均接受了初始手术或活检以确诊GBM,随后进行了放疗或放化疗。
与STS相比,LTS的无进展生存期(PFS)中位数为25.4个月(2.3 - 97.8个月),总生存期(OS)为55.9个月(38.2 - 98.6个月),而STS的PFS显著更低,为4.2个月(1.4 - 10.2个月),OS为6.6个月(2.2 - 11.6个月)(每组p < 0.001)。生存分析表明,60岁以下(p < 0.001)、全切状态(p < 0.001)以及肿瘤位置未与SVZ接触(p = 0.05)是生存延长的显著因素。
我们的研究结果强调,GBM患者的生存情况存在异质性且受多种因素影响。本研究证实,肿瘤相对于SVZ的位置与生存显著相关。