Ho Vincent K Y, Reijneveld Jaap C, Enting Roelien H, Bienfait Henri P, Robe Pierre, Baumert Brigitta G, Visser Otto
Comprehensive Cancer Centre the Netherlands, Utrecht, The Netherlands.
VU University Medical Centre, Amsterdam, The Netherlands.
Eur J Cancer. 2014 Sep;50(13):2309-18. doi: 10.1016/j.ejca.2014.05.019. Epub 2014 Jun 24.
Tumours of the central nervous system (CNS) represent a relatively rare but serious health burden. This study provides insight into the incidence and survival patterns of gliomas in the Netherlands diagnosed in adult patients during the time period 1989-2010, with a focus on glioblastoma and low-grade gliomas.
Data on 21,085 gliomas (excluding grade I tumours) were obtained from the Netherlands Cancer Registry, including tumours of the CNS without pathological confirmation. We calculated the age-standardised incidence rates and the estimated annual percentage change (EAPC) for all glioma subtypes. Crude and relative survival rates were estimated using information on the vital status obtained from the Dutch Municipal Personal Records Database.
Incidence of gliomas in adults increased over time, from 4.9 per 100,000 in 1989 to 5.9 in 2010 (EAPC 0.7%, p<0.001). Two thirds were astrocytoma, 10% oligodendroglioma/oligoastrocytoma, 3% ependymoma and 21% were unspecified. Within the group of astrocytic tumours, the proportion of glioblastoma rose, while the proportion of anaplastic and unspecified astrocytoma decreased. Unspecified neoplasms also decreased, but this was significant only after 2005. Over the course of the study period, glioblastoma patients more often received multimodality treatment with chemotherapy concomitant and adjuvant to radiotherapy. The crude two-year survival rate of glioblastoma patients improved significantly, from 5% in the time period 1989-1994 to 15% in 2006-2010, with median survival increasing from 5.5 to 9 months. The incidence of low-grade gliomas did not change over time. Survival rates for low-grade oligodendroglial and mixed tumours show a modest improvement.
The incidence rate for the total group of gliomas slightly increased, with a decrease of anaplastic and unspecified tumours and an increase of glioblastoma. Following the introduction of combined chemoradiation, two-year survival rates for glioblastoma significantly improved. Survival improved for low-grade gliomas except for low-grade astrocytic tumours.
中枢神经系统（CNS）肿瘤虽相对罕见，但却是严重的健康负担。本研究深入探讨了1989年至2010年期间荷兰成年患者中诊断出的胶质瘤的发病率和生存模式，重点关注胶质母细胞瘤和低级别胶质瘤。
从荷兰癌症登记处获取了21,085例胶质瘤（不包括I级肿瘤）的数据，包括未经病理证实的中枢神经系统肿瘤。我们计算了所有胶质瘤亚型的年龄标准化发病率和估计的年度百分比变化（EAPC）。使用从荷兰市政个人记录数据库获得的生命状态信息估计粗生存率和相对生存率。
成人胶质瘤的发病率随时间增加，从1989年的每10万人4.9例增至2010年的5.9例（EAPC 0.7%，p<0.001）。三分之二为星形细胞瘤，10%为少突胶质细胞瘤/少突星形细胞瘤，3%为室管膜瘤，21%未明确分类。在星形细胞肿瘤组中，胶质母细胞瘤的比例上升，而间变性和未明确分类的星形细胞瘤的比例下降。未明确分类的肿瘤也有所减少，但仅在2005年后才具有统计学意义。在研究期间，胶质母细胞瘤患者更常接受化疗联合放疗的多模式治疗。胶质母细胞瘤患者的粗两年生存率显著提高，从1989 - 1994年期间的5%提高到2006 - 2010年的15%，中位生存期从5.5个月增加到9个月。低级别胶质瘤的发病率未随时间变化。低级别少突胶质细胞瘤和混合性肿瘤的生存率有适度提高。
胶质瘤总体发病率略有上升，间变性和未明确分类的肿瘤减少，胶质母细胞瘤增加。联合放化疗引入后，胶质母细胞瘤的两年生存率显著提高。除低级别星形细胞肿瘤外，低级别胶质瘤的生存率有所改善。
