Hamza Mohamed A, Kamiya-Matsuoka Carlos, Liu Diane, Yuan Ying, Puduvalli Vinay K
Department of Neuro-oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
OhioHealth Riverside Hospital, Columbus, OH, USA.
J Neurooncol. 2016 Feb;126(3):527-33. doi: 10.1007/s11060-015-1992-x. Epub 2015 Nov 13.
Patients with malignant glioma who are also diagnosed with one or more primary neoplasms of other organs present a unique challenge in both determining prognosis and clinical management. The overlapping impact of the malignancies and their treatment result in confounding variables that may adversely affect optimal management of such patients. Additionally, the glioma-related characteristics and survival outcome of these patients is not well-defined. In this retrospective chart and data review from our longitudinal database, we identified patients with malignant glioma including anaplastic glioma and glioblastoma, diagnosed between January 2005 and June 2011, who were also diagnosed with other non-CNS primary neoplasms. Patients with known genetic syndromes were excluded. The data was analyzed to determine the clinical characteristics and glioma-related survival. A total of 204 patients with malignant glioma (165 glioblastoma and 39 anaplastic glioma) were identified. There was no significant difference in the overall survival or progression-free survival between patients with malignant glioma plus non-CNS primary neoplasm when compared with patients with malignant glioma only. In patients with glioblastoma and non-CNS malignancy, the duration between diagnosis of glioblastoma and non-CNS neoplasms did not significantly alter glioma-related survival. Patients with malignant glioma who were diagnosed with other non-CNS malignancy have survival outcome comparable to those with malignant glioma only. The duration between diagnosis of glioblastoma and diagnosis of non-CNS neoplasms did not affect survival. Further prospective studies specifically addressing survival and molecular characteristics of patients with malignant glioma plus non-CNS cancers are recommended.
同时被诊断出患有一种或多种其他器官原发性肿瘤的恶性胶质瘤患者,在确定预后和临床管理方面面临着独特的挑战。恶性肿瘤及其治疗的重叠影响会导致一些混淆变量,可能对这类患者的最佳管理产生不利影响。此外,这些患者与胶质瘤相关的特征和生存结果尚不明确。在本次对我们纵向数据库的回顾性图表和数据审查中,我们确定了2005年1月至2011年6月期间被诊断为恶性胶质瘤(包括间变性胶质瘤和胶质母细胞瘤)且同时还被诊断出患有其他非中枢神经系统原发性肿瘤的患者。已知患有遗传综合征的患者被排除在外。对数据进行分析以确定临床特征和与胶质瘤相关的生存率。共确定了204例恶性胶质瘤患者(165例胶质母细胞瘤和39例间变性胶质瘤)。与仅患有恶性胶质瘤的患者相比,患有恶性胶质瘤加非中枢神经系统原发性肿瘤的患者在总生存期或无进展生存期方面没有显著差异。在患有胶质母细胞瘤和非中枢神经系统恶性肿瘤的患者中,胶质母细胞瘤诊断与非中枢神经系统肿瘤诊断之间的时间间隔并未显著改变与胶质瘤相关的生存率。被诊断出患有其他非中枢神经系统恶性肿瘤的恶性胶质瘤患者的生存结果与仅患有恶性胶质瘤的患者相当。胶质母细胞瘤诊断与非中枢神经系统肿瘤诊断之间的时间间隔不影响生存。建议开展进一步的前瞻性研究,专门针对患有恶性胶质瘤加非中枢神经系统癌症患者的生存情况和分子特征进行研究。