Guden M, Ayata H B, Ceylan C, Kilic A, Engin K
Department of Radiation Oncology, Anadolu Medical Center, Gebze 41400 Kocaeli, Turkey.
Indian J Cancer. 2016 Jul-Sep;53(3):382-386. doi: 10.4103/0019-509X.200664.
The aim of this study is to offer survival following radiation therapy using intensity-modulated radiotherapy or volumetric arc therapy with temozolomide in patients with glioblastoma.
Ninety-two previously treated patients with high-grade glioma (World Health Organization [WHO] grade IV) were studied in Anadolu Medical Center, Department of Radiation Oncology, between January 2006 and July 2015. The diagnosis was established by pathology in all cases. The median age was 59 years (range, 19-86 years). The median tumor diameter was 45 mm, and the rate of the multicentric tumors was 16.3%. The location of the tumor was temporal in 33.7%, parietal in 14.1%, frontal in 23.9%, occipital in 9.8%, and others in 18.5%. The gross total and subtotal resection were performed in 60.9% of the patients, partial resection in 26.1%, and only stereotactic biopsy in 13.0% of the patients.
The median overall survival (OS) was 33.01 ± 4.76 months (95% confidence interval 25.64-40.38 months). 1, 2, and 5 years OS was 74.3%, 44.3%, and 31.8%, respectively. The median progression-free survival (PFS) was 27.36 ± 3.87 months (95% confidence interval 19.82-34.89 months). 1, 2, and 5 years PFS was 62.7%, 32.6%, and 27.2%, respectively. On univariate analysis, gender, extent of surgery, tumor size, Karnofsky performance status, and tumor suppressor gene (P53) were significant predictors of OS and PFS. On multivariate analysis, gender (PFS: P = 0.006, OS: P = 0.003), extent of surgery (PFS: P = 0.004, OS: P = 0.012), P53 (PFS: P = 0.003, OS: P = 0.021), and size of tumor (PFS: P = 0.005, OS: 0.012) remained significantly associated with PFS and OS. There is no statistically significant in OS and PFS between female and male (OS: log-rank: 0.79 P = 0.375, PFS: log-rank: 0.54 P = 0.465). PSF and OS were not significantly significant with total/near total resection compared with partial resection (PSF: P = 0.46 log-rank = 0.54, OS: P = 0.340 log-rank = 0.91). Patients with P53 <50% value and patients with P53 >50% value were compared and results were not found statistically significant (PSF: P = 0.917 log-rank = 0.01, OS: P = 0.892 log-rank = 0.02). For patients with tumor size <0 mm, small tumor size did not improve the PSF and OS (PSF: P = 0.291 log-rank = 1.11, OS: P = 0.288 log-rank = 1.13).
Ninety-two previously treated patients with high-grade glioma (WHO Grade IV) were evaluated with multivariate analysis. Gender, extent of surgery, P53, and tumor size were found as prognostic factors affecting on survival.
本研究旨在探讨胶质母细胞瘤患者采用调强放疗或容积弧形调强放疗联合替莫唑胺进行放射治疗后的生存率。
2006年1月至2015年7月期间，在安纳托利亚医疗中心放射肿瘤学系对92例先前接受过治疗的高级别胶质瘤（世界卫生组织[WHO]IV级）患者进行了研究。所有病例均经病理确诊。中位年龄为59岁（范围19 - 86岁）。肿瘤中位直径为45mm，多中心肿瘤发生率为16.3%。肿瘤位于颞叶的占33.7%，顶叶的占14.1%，额叶的占23.9%，枕叶的占9.8%，其他部位的占18.5%。60.9%的患者进行了大体全切和次全切，26.1%的患者进行了部分切除，13.0%的患者仅进行了立体定向活检。
中位总生存期（OS）为33.01±4.76个月（95%置信区间25.64 - 40.38个月）。1年、2年和5年总生存率分别为74.3%、44.3%和31.8%。中位无进展生存期（PFS）为27.36±3.87个月（95%置信区间19.82 - 34.89个月）。1年、2年和5年无进展生存率分别为62.7%、32.6%和27.2%。单因素分析显示，性别、手术范围、肿瘤大小、卡诺夫斯基功能状态和肿瘤抑制基因（P53）是总生存期和无进展生存期的重要预测因素。多因素分析显示，性别（PFS：P = 0.006，OS：P = 0.
