低级别幕上胶质瘤成年患者的总生存期：单机构十年随访
Overall survival in adult patients with low-grade, supratentorial glioma: Ten years' follow up at a single institution.
作者信息
Kashi Amir Shahram Yousefi, Rakhsha Afshin, Houshyari Mohammad
机构信息
Assistant Professor, Shohada-e-Tajrish Hospital, Department of Radiation Oncology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Electron Physician. 2015 Jul 20;7(3):1114-20. doi: 10.14661/2015.1114-1120. eCollection 2015 Jul.
BACKGROUND
Low-grade gliomas (LGGs) are the second most prevalent type of primary brain tumors in adults. The prognosis for LGGs can differ according to the clinical-pathological prognostic factors determined during diagnosis and treatment. The purpose of this study was to identify 10-year, disease-free survival (DFS), 10-year overall survival (OS), and related clinical-pathological prognostic factors of adult patients with supratentorial, low-grade gliomas who were treated with or without surgery and radiation therapy.
METHODS
The study included 110 patients who were confirmed to have low-grade, supratentorial gliomas and who had received surgery and adjuvant radiation therapy or salvage radiotherapy as part of their treatment. These patients were followed by the radiation-oncology ward at Shohada-e-Tajrish Hospital in Tehran, Iran, between 2002 and 2012. The log-rank test (univariate) and the Cox proportional hazards model (multivariate) were used to examine the 10-year DFS and OS and to assess the strengths of various histo-clinical factors relative to 10-year DFS and OS.
RESULTS
The study included 110 patients for whom 10-year DFS and OS were found to be 23 and 28%, respectively. Favorable prognostic factors in the univariate analysis using the Kaplan-Meier 10-year OS analysis were the following: age below 40, karnofsky performance status (KPS) more than 70, the presence of oligodendroglioma, tumor size of < 5 cm, and gross-total resection (p=0.02, p=0.01, p=0.03, p=0.01, p=0.02, respectively). Good prognostic factors in multivariate analysis using the Cox regression model were as follows: age below 40, the presence of oligodendroglioma, tumor size< 5 cm, and gross total resection in10-year OS (p=0.01, p=0.03, p=0.00, p=0.02, respectively).
CONCLUSIONS
Gross-total resection, tumor size < 5 cm, age below 40, and the presence of oligodendroglioma had better 10-year DFS and OS rates. We recommend that all patients with LGG tumors be referred to neuro-oncology centers that have sufficient experience to achieve the best results of treatment.
背景
低级别胶质瘤（LGGs）是成人中第二常见的原发性脑肿瘤类型。LGGs的预后可能因诊断和治疗期间确定的临床病理预后因素而有所不同。本研究的目的是确定接受或未接受手术及放射治疗的幕上低级别胶质瘤成年患者的10年无病生存率（DFS）、10年总生存率（OS）以及相关的临床病理预后因素。
方法
该研究纳入了110例确诊为幕上低级别胶质瘤且接受了手术及辅助放射治疗或挽救性放疗的患者。这些患者于2002年至2012年期间在伊朗德黑兰的Shohada - e - Tajrish医院放疗科接受随访。采用对数秩检验（单变量）和Cox比例风险模型（多变量）来检验10年DFS和OS，并评估各种组织临床因素相对于10年DFS和OS的强度。
结果
该研究纳入的110例患者中，10年DFS和OS分别为23%和28%。在使用Kaplan - Meier 10年OS分析的单变量分析中，有利的预后因素如下：年龄低于40岁、卡诺夫斯基功能状态（KPS）高于70、存在少突胶质细胞瘤、肿瘤大小<5 cm以及全切除（p分别为0.02、0.01、0.03、0.01、0.02）。在使用Cox回归模型的多变量分析中，良好的预后因素如下：年龄低于40岁、存在少突胶质细胞瘤、肿瘤大小<5 cm以及10年OS中的全切除（p分别为0.01、0.03、0.00、0.02）。
结论
全切除、肿瘤大小<5 cm、年龄低于40岁以及存在少突胶质细胞瘤具有更好的10年DFS和OS率。我们建议所有LGG肿瘤患者转诊至有足够经验以实现最佳治疗效果的神经肿瘤中心。
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