Mallick Supriya, Benson Rony, Melgandi Wineeta, Rath Goura K
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
Int J Radiat Oncol Biol Phys. 2017 Dec 1;99(5):1199-1206. doi: 10.1016/j.ijrobp.2017.08.012. Epub 2017 Aug 18.
The optimal treatment of patients with choroid plexus carcinoma (CPC) is unclear. We conducted a systematic review and meta-analysis of individual patient information to determine the effect of surgery, adjuvant therapy, and other prognostic factors for CPC.
A comprehensive search of the PubMed and Google Scholar databases was performed using the following MeSH terms to find all possible reports on CPC: choroid plexus tumor; choroid plexus carcinoma; choroid plexus carcinoma AND treatment; and choroid plexus carcinoma AND survival. We performed an individual patient data analysis to assess the strength of the potential associations between different variables and the outcomes for patients with CPC.
Data from 284 patients were retrieved from 89 studies. The median patient age was 2 years, with 26% patients diagnosed in the first year of their life. Of these 284 patients, 52.8% had undergone gross total resection (GTR) or near total resection. The median follow-up period for the entire cohort was 10.8 months. The median progression-free survival (PFS) was 13 months (95% confidence interval 8.14-17.8). PFS was better for patients >aged 5 years and those who had undergone GTR. The median overall survival (OS) was 29 months (95% confidence interval 16.3-41.7). OS was better for patients aged >5 years, those who had undergone GTR, those who had received adjuvant treatment, and those with a parenchymal tumor site.
CPC is an aggressive tumor, with a median PFS of 13 months and median OS of 29 months. All patients should undergo maximal safe resection, because GTR is associated with improved survival. The use of adjuvant radiation and chemotherapy were also associated with improved outcomes.
脉络丛癌(CPC)患者的最佳治疗方案尚不清楚。我们对个体患者信息进行了系统评价和荟萃分析,以确定手术、辅助治疗及其他预后因素对CPC的影响。
使用以下医学主题词对PubMed和谷歌学术数据库进行全面检索,以查找所有关于CPC的可能报告:脉络丛肿瘤;脉络丛癌;脉络丛癌与治疗;脉络丛癌与生存。我们进行了个体患者数据分析,以评估不同变量与CPC患者预后之间潜在关联的强度。
从89项研究中检索到284例患者的数据。患者中位年龄为2岁,26%的患者在出生后第一年被诊断。在这284例患者中,52.8%接受了全切除(GTR)或近全切除。整个队列的中位随访期为10.8个月。中位无进展生存期(PFS)为13个月(95%置信区间8.14 - 17.8)。5岁以上患者和接受GTR的患者PFS更好。中位总生存期(OS)为29个月(95%置信区间16.3 - 41.7)。5岁以上患者、接受GTR的患者、接受辅助治疗的患者以及肿瘤位于实质部位的患者OS更好。
CPC是一种侵袭性肿瘤,中位PFS为13个月,中位OS为29个月。所有患者均应接受最大安全切除,因为GTR与生存改善相关。辅助放疗和化疗的使用也与更好的预后相关。