Brodbelt Andrew, Greenberg David, Winters Tim, Williams Matt, Vernon Sally, Collins V Peter
The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool L9 7LJ, UK.
National Cancer Registration Service, Public Health England, Unit C, Magog Court, Hinton Way, Cambridge CB22 3AD, UK.
Eur J Cancer. 2015 Mar;51(4):533-542. doi: 10.1016/j.ejca.2014.12.014. Epub 2015 Feb 3.
Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumour in adults, with a poor prognosis. Changing treatment paradigms suggest improved outcome, but whole nation data for England is scarce. The aim of this report is to examine the incidence of patients with glioblastoma in England, and to assess the influence of gender, age, geographical region and treatment on outcome.
A search strategy encompassing all patients coded with GBM and treated from January 2007 to December 2011 was obtained from data linkage between the National Cancer Registration Service and Hospital Episode Statistics for England.
There were 10,743 patients coded with GBM in this 5-year period (6451 male, 4292 female), giving an overall national age standardised incidence of 4.64/100,000/year. Incidence increases with age. Median survival overall was 6.1 months. One, 2 and 5-year survivals, were 28.4%, 11.5% and 3.4% respectively. Age stratified median survivals decreased significantly (p<0.0001) with increasing age from 16.2 months for the 20-44 year age group, to 7.9 months for the 45-69 years, and 3.2 months for 70+years. In the maximal treatment subgroup, patients aged up to 69 years had a median survival of 14.9 months. Patients over 60 years were less likely to receive maximal combination treatment but median survival was better with maximal treatment at all ages.
The overall outcome for patients with GBM remains poor. However, aggressive treatment at every age group is associated with extended survival similar to that described in clinical trials.
胶质母细胞瘤(GBM)是成人中最常见且侵袭性最强的原发性恶性脑肿瘤,预后较差。不断变化的治疗模式表明预后有所改善,但英格兰的全国性数据却很匮乏。本报告旨在研究英格兰胶质母细胞瘤患者的发病率,并评估性别、年龄、地理区域和治疗对预后的影响。
通过将国家癌症登记服务中心与英格兰医院事件统计数据进行数据链接,获得了涵盖2007年1月至2011年12月期间所有编码为GBM并接受治疗的患者的搜索策略。
在这5年期间,有10743例患者被编码为GBM(男性6451例,女性4292例),全国总体年龄标准化发病率为每年4.64/10万。发病率随年龄增长而增加。总体中位生存期为6.1个月。1年、2年和5年生存率分别为28.4%、11.5%和3.4%。按年龄分层的中位生存期随着年龄的增加而显著降低(p<0.0001),从20 - 44岁年龄组的16.2个月降至45 - 69岁的7.9个月,70岁及以上的为3.2个月。在最大治疗亚组中,69岁及以下患者的中位生存期为14.9个月。60岁以上患者接受最大联合治疗的可能性较小,但各年龄段接受最大治疗的患者中位生存期更好。
GBM患者的总体预后仍然很差。然而,每个年龄组的积极治疗都与生存期延长相关,类似于临床试验中所描述的情况。