Lee Jiwook, Park Sung Hyun, Kim Young Zoon
Division of Neuro-Oncology and Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Brain Tumor Res Treat. 2018 Apr;6(1):22-30. doi: 10.14791/btrt.2018.6.e1. Epub 2018 Apr 2.
The aims of this study were to investigate the role of the Neurological Assessment of Neuro-Oncology (NANO) scale in predicting the prognosis of patients with glioblastoma, and compare these results to predicted data of the Karnofsky Performance Scale (KPS), and Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) performance status. Additionally, we examined other prognostic factors in glioblastoma patients.
The medical records of 76 patients with a new diagnosis of histologically ascertained glioblastoma in the period from January 2002 to December 2015 at the authors' institution were retrospectively reviewed. Clinical factors, including epidemiologic, radiologic, and therapeutic values were reviewed as well as the performance status assessed by the KPS, ECOG/WHO performance status, and NANO scale.
The mean overall survival was 19.8 months (95% confidence interval 15.2-25.4 months). At initial diagnosis, the mean value [±standard deviation (SD)] of KPS score, ECOG/WHO performance status, and NANO scale were 81 (±7.4), 1.3 (±0.6), and 7.3 (±3.8), respectively. Multivariate analysis for predicting survival showed odds ratios of KPS score, ECOG/WHO performance status, and NANO scale were 2.502 (≥80 vs. <80; p=0.024), 1.691 (0-1 vs. 2-5; p=0.047), and 2.763 (0-7 vs. 8-23; p=0.020), respectively. At the time of progression, the mean value (±SD) of KPS score, ECOG/WHO performance status, and NANO scale were 69 (±8.2), 1.6 (±0.7), and 11.4 (±4.2), respectively; multivariate analysis for predicting survival showed that the odd ratios for KPS score, ECOG/WHO performance status, and NANO scale were 2.007 (≥80 vs. <80; p=0.035), 1.321 (0-1 vs. 2-5; p=0.143), and 3.182 (0-7 vs. 8-23; p=0.002), respectively.
The NANO scale provided a more detailed and objective measure of neurologic function than that currently used for predicting the prognosis of glioblastoma patients, especially at the time of progression.
本研究旨在探讨神经肿瘤学神经评估（NANO）量表在预测胶质母细胞瘤患者预后中的作用，并将这些结果与卡诺夫斯基功能状态量表（KPS）以及东部肿瘤协作组（ECOG）/世界卫生组织（WHO）功能状态的预测数据进行比较。此外，我们还研究了胶质母细胞瘤患者的其他预后因素。
回顾性分析了2002年1月至2015年12月在作者所在机构新诊断为组织学确诊胶质母细胞瘤的76例患者的病历。回顾了临床因素，包括流行病学、放射学和治疗学价值，以及通过KPS、ECOG/WHO功能状态和NANO量表评估的功能状态。
平均总生存期为19.8个月（95%置信区间15.2 - 25.4个月）。初诊时，KPS评分、ECOG/WHO功能状态和NANO量表的平均值[±标准差（SD）]分别为81（±7.4）、1.3（±0.6）和7.3（±3.8）。预测生存的多因素分析显示，KPS评分、ECOG/WHO功能状态和NANO量表的比值比分别为2.502（≥80 vs. <80；p = 0.024）、1.691（0 - 1 vs. 2 - 5；p = 0.047）和2.763（0 - 7 vs. 8 - 23；p = 0.020）。病情进展时，KPS评分、ECOG/WHO功能状态和NANO量表的平均值（±SD）分别为69（±8.2）、1.6（±0.7）和11.4（±4.2）；预测生存的多因素分析显示，KPS评分、ECOG/WHO功能状态和NANO量表的比值比分别为2.007（≥80 vs. <80；p = 0.035）、1.321（0 - 1 vs. 2 - 5；p = 0.143）和3.182（0 - 7 vs. 8 - 23；p = 0.002）。
与目前用于预测胶质母细胞瘤患者预后的方法相比，NANO量表能提供更详细、客观的神经功能测量，尤其是在病情进展时。
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