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成人室管膜瘤患者的临床表现及预后

Clinical presentation and outcomes for adult ependymoma patients.

作者信息

Acquaye Alvina A, Vera Elizabeth, Gilbert Mark R, Armstrong Terri S

机构信息

University of Texas Health Science Center, Houston, Texas.

National Institutes of Health, Bethesda, Maryland.

出版信息

Cancer. 2017 Feb 1;123(3):494-501. doi: 10.1002/cncr.30355. Epub 2016 Sep 28.

Abstract

BACKGROUND

Outcomes projects can be a catalyst for determining disease- and treatment-related consequences for patients with rare tumors. The Adult Ependymoma Outcomes (AEO) survey uses self-reported experience to evaluate how this tumor affects patient groups throughout the illness trajectory.

METHODS

Patients completed the AEO survey via a Web-based portal. The survey included questions on treatment, tumor recurrence, and current health status; the MD Anderson Symptom Inventory Brain Tumor and Spine Tumor modules; and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).

RESULTS

The sample included 264 participants (57% female) with a median age of 46 years (range, 18-77 years). Radiation treatment was commonly used for patients who had brain involvement (χ (1) = 20.7; P < .001), underwent a partial resection (43%; χ (3) = 15.4; P < .001), or had a grade 3 tumor (41%; χ (2) = 18.8; P < .001). Recurrence occurred in a small group (29%), with grade 1 tumor patients 2.6 times more likely and grade 3 tumor patients 2.5 times more likely to experience recurrence than those with grade 2 tumors. Spine tumor patients had a higher symptom burden (mean, 2.8; scale, 0-10) than brain tumor patients (t(247) = -4.0), and they reported more moderate to severe symptoms (rating ≥ 5; 29%) than their counterparts (18%). Within the physical health portion of the SF-36, spine tumor patients reported worse health with respect to bodily pain (t(249) = 6.8; P < .001), physical functioning (t(252) = 4.1; P < .001), and vitality (t(202.2) = 3.0; P < .003).

CONCLUSIONS

These results demonstrate the feasibility of implementing outcomes projects that report on the clinical and demographic characteristics of a rare patient population, and they underscore the importance of outcomes data in understanding disease-related issues. Cancer 2017;123:494-501. © 2016 American Cancer Society.

摘要

背景

结果项目可以成为确定罕见肿瘤患者疾病和治疗相关后果的催化剂。成人室管膜瘤结果(AEO)调查使用自我报告的经历来评估这种肿瘤在整个疾病轨迹中如何影响患者群体。

方法

患者通过基于网络的门户完成AEO调查。该调查包括有关治疗、肿瘤复发和当前健康状况的问题;MD安德森症状量表脑肿瘤和脊柱肿瘤模块;以及医学结果研究36项简短健康调查(SF-36)。

结果

样本包括264名参与者(57%为女性),中位年龄为46岁(范围18 - 77岁)。放射治疗常用于脑部受累的患者(χ(1)=20.7;P<.001)、接受部分切除术的患者(43%;χ(3)=15.4;P<.001)或患有3级肿瘤的患者(41%;χ(2)=18.8;P<.001)。一小部分患者(29%)出现复发,1级肿瘤患者复发的可能性是2级肿瘤患者的2.6倍,3级肿瘤患者复发的可能性是2级肿瘤患者的2.5倍。脊柱肿瘤患者的症状负担(平均2.8;范围0 - 10)高于脑肿瘤患者(t(247)= -4.0),且他们报告的中度至重度症状(评分≥5;29%)多于脑肿瘤患者(18%)。在SF-36的身体健康部分,脊柱肿瘤患者在身体疼痛(t(249)=6.8;P<.001)、身体功能(t(252)=4.1;P<.001)和活力(t(202.2)=3.0;P<.003)方面报告的健康状况较差。

结论

这些结果证明了实施报告罕见患者群体临床和人口统计学特征的结果项目的可行性,并强调了结果数据在理解疾病相关问题中的重要性。《癌症》2017年;123:494 - 501。©2016美国癌症协会。

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