Valiyaveettil Deepthi, Malik Monica, Joseph Deepa, Ahmed Syed Fayaz, Kothwal Syed Akram
Department of Radiation Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
South Asian J Cancer. 2018 Jan-Mar;7(1):1-4. doi: 10.4103/sajc.sajc_55_17.
There is lack of clear evidence and treatment guidelines for anaplastic gliomas (AGs) with very few studies focusing exclusively on these patients. The aim of the study was to analyze the clinical profile and survival in these patients.
Patients of AGs treated with radiation and concurrent ± adjuvant chemotherapy from January 2010 to December 2015 were analyzed. Statistical analysis was done using SPSS version 20 software.
A total of 100 patients were included in the study. The median age was 35 years (range 6-68 years). Eighty-four patients had follow-up details and were included for survival analysis. The 5-year overall survival (OS) was 58%. Age, presentation with seizures, and focal neurological deficit were not found to significantly influence survival. The 5-year survival for oligodendroglioma and astrocytoma was 69% and 52%, respectively. Patients with Karnofsky Performance Score (KPS) of ≥70 had a significantly better 5-year OS (65%) as compared to those with KPS <70 (33%) ( = 0.000). The use of adjuvant temozolomide (TMZ) showed longer 5-year OS of 67.7% compared to 36% in patients who did not receive adjuvant chemotherapy ( = 0.018). Patients receiving both concurrent and adjuvant TMZ showed longer 5-year OS (68.5% vs. 40%, = 0.010). Twenty-two patients had recurrence with average time to recurrence being 37 months. Fourteen patients underwent salvage surgery and two patients received reirradiation.
OS significantly correlated with KPS and receipt of concurrent and adjuvant chemotherapy with TMZ. Therefore, adjuvant radiation with concurrent and adjuvant TMZ should be the standard of care for AGs.
间变性胶质瘤（AGs）缺乏明确的证据和治疗指南，仅有极少的研究专门针对这些患者。本研究的目的是分析这些患者的临床特征和生存率。
分析了2010年1月至2015年12月接受放疗及同步±辅助化疗的AGs患者。使用SPSS 20版软件进行统计分析。
本研究共纳入100例患者。中位年龄为35岁（范围6 - 68岁）。84例患者有随访细节并纳入生存分析。5年总生存率（OS）为58%。未发现年龄、癫痫发作表现和局灶性神经功能缺损对生存率有显著影响。少突胶质细胞瘤和星形细胞瘤的5年生存率分别为69%和52%。卡氏功能状态评分（KPS）≥70的患者5年OS显著优于KPS <70的患者（65% 对33%，P = 0.000）。与未接受辅助化疗的患者相比，使用辅助替莫唑胺（TMZ）的患者5年OS更长，为67.7% 对36%（P = 0.018）。接受同步和辅助TMZ治疗的患者5年OS更长（68.5% 对40%，P = 0.010）。22例患者复发，平均复发时间为37个月。14例患者接受了挽救性手术，2例患者接受了再放疗。
OS与KPS以及同步和辅助TMZ化疗的接受情况显著相关。因此，同步和辅助TMZ的辅助放疗应作为AGs的标准治疗方案。
