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中枢神经细胞瘤手术切除后辅助放疗的长期疗效

Long-term outcomes of adjuvant radiotherapy after surgical resection of central neurocytoma.

作者信息

Chen Yi-Dong, Li Wen-Bin, Feng Jin, Qiu Xiao-Guang

机构信息

Capital Medical University Cancer Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

出版信息

Radiat Oncol. 2014 Nov 6;9:242. doi: 10.1186/s13014-014-0242-2.

Abstract

BACKGROUND AND PURPOSE

The role of adjuvant radiotherapy for central neurocytomas (CNs) is not clear. Therefore, we aimed to examine the clinical outcomes of treating histologically confirmed CNs with adjuvant RT after surgical resection.

MATERIAL AND METHODS

Sixty-three CN patients were retrospectively evaluated: 24 patients underwent gross total resection (GTR); 28, subtotal resection (STR); 9, partial resection (PR), and 2, biopsy (Bx). They underwent adjuvant RT after surgery (median dose, 54 Gy).

RESULTS

The median follow-up was 69 months (15-129 months). The 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 94.4% and 95% after GTR + RT, 96.4% and 100% after STR + RT, and 100% and 90.9% after PR + RT. Only three patients had tumor recurrence: at the primary site at 30 and 24 months in two GTR + PR patients, and dissemination to the spinal cord at 75 months in one STR + RT patient. Thirty-eight (63.3%) patients experienced late neurotoxicity (28, grade 1; 7, grade 2; 3, grade 3). Short-term memory impairment was the most common toxicity.

CONCLUSIONS

RT after incomplete resection (IR) led to OS and PFS comparable to those for GTR. Considering the excellent outcomes and limited late toxicity, adjuvant RT maybe a good option for CN patients who undergo IR.

摘要

背景与目的

辅助放疗在中枢神经细胞瘤(CNs)中的作用尚不清楚。因此,我们旨在研究手术切除后接受辅助放疗治疗组织学确诊的CNs的临床结局。

材料与方法

对63例CN患者进行回顾性评估:24例患者接受了全切除(GTR);28例,次全切除(STR);9例,部分切除(PR),2例,活检(Bx)。他们在术后接受了辅助放疗(中位剂量,54 Gy)。

结果

中位随访时间为69个月(15 - 129个月)。GTR + RT后5年总生存率(OS)和5年无进展生存率(PFS)分别为94.4%和95%,STR + RT后为96.4%和100%,PR + RT后为100%和90.9%。仅3例患者出现肿瘤复发:2例GTR + PR患者分别在30个月和24个月时在原发部位复发,1例STR + RT患者在75个月时肿瘤播散至脊髓。38例(63.3%)患者出现晚期神经毒性(28例为1级;7例为2级;3例为3级)。短期记忆障碍是最常见的毒性反应。

结论

不完全切除(IR)后放疗导致的OS和PFS与GTR相当。考虑到良好的结局和有限的晚期毒性,辅助放疗可能是接受IR的CN患者的一个不错选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f0/4236432/3910bc6e4a83/13014_2014_242_Fig1_HTML.jpg

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