Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng District, Beijing, People's Republic of China.
J Neurooncol. 2019 Apr;142(2):263-272. doi: 10.1007/s11060-019-03089-z. Epub 2019 Jan 7.
We aim to delineate the clinical characteristics of patients with primary intracranial solitary plasmacytoma (PISPC) and prognostic factors for their outcomes.
This study retrospectively reviewed 17 patients with PISPC from our center and an additional 70 cases of PISPC published previously to analyze outcome predictors.
The entire cohort included 38 (43.7%) males and 49 (56.3%) females with a mean age of 54 years. Skull base tumors were found in 49 (56.3%) patients. Gross total resection (GTR) was achieved in 31 (35.6%) patients. Postoperative adjuvant treatments, including radiotherapy (RT) alone, chemotherapy (CMT) alone, and RT + CMT were administered in 49 (56.3%) patients, 3 (3.5%) patients, and 16 (18.4%) patients, respectively. After a median follow-up of 24 (mean 42.4) months, the 5-year disease progression-free survival (PFS), recurrence-free survival (RFS), multiple myeloma (MM)-free survival (MMFS), and overall survival (OS) were 52.9%, 76.2%, 69.6%, and 76.1%, respectively. Multivariate analysis unveiled that a skull base tumor location (HR 2.395, p = 0.040) and no RT (HR 3.115, p = 0.004) were negative prognostic factors for PFS, no RT (HR 10.526, p = 0.003) for RFS, each 1-year increase in age (HR 1.039, p = 0.049) for MMFS, and increasing age (HR 1.052, p = 0.043) and CMT (HR 6.022, p = 0.005) were risk factors for OS. However, GTR did not benefit the aforementioned outcomes.
For patients with presumed PISPC, a biopsy followed by RT is recommended for skull base PISPC. However, the role of CMT is still not clear. Our findings need to be verified in a larger prospective cohort in the future. Systematic review registration number CRD42018098782.
我们旨在描绘原发性颅内孤立性浆细胞瘤（PISPC）患者的临床特征和预后因素。
本研究回顾性分析了来自我们中心的 17 例 PISPC 患者和之前发表的 70 例 PISPC 病例，以分析预后预测因素。
整个队列包括 38 例（43.7%）男性和 49 例（56.3%）女性，平均年龄为 54 岁。49 例（56.3%）患者存在颅底肿瘤。31 例（35.6%）患者实现了大体全切除（GTR）。49 例（56.3%）患者接受了术后辅助治疗，包括单独放疗（RT）、单独化疗（CMT）和 RT+CMT，3 例（3.5%）患者接受了单独 CMT，16 例（18.4%）患者接受了 RT+CMT。中位随访 24 个月（平均 42.4 个月）后，5 年疾病无进展生存（PFS）、无复发生存（RFS）、无多发性骨髓瘤（MM）生存（MMFS）和总生存（OS）率分别为 52.9%、76.2%、69.6%和 76.1%。多变量分析显示，颅底肿瘤位置（HR 2.395，p=0.040）和无 RT（HR 3.115，p=0.004）是 PFS 的负预后因素，无 RT（HR 10.526，p=0.003）是 RFS 的负预后因素，年龄每增加 1 年（HR 1.039，p=0.049）是 MMFS 的负预后因素，年龄增加（HR 1.052，p=0.043）和 CMT（HR 6.022，p=0.005）是 OS 的危险因素。然而，GTR 并没有使上述结果受益。
对于疑似 PISPC 的患者，建议对颅底 PISPC 进行活检后行 RT。然而，CMT 的作用仍不清楚。我们的发现需要在未来更大的前瞻性队列中进行验证。系统评价注册号 CRD42018098782。
