Department of Neurosurgery, Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, 45 Changchun Street, Western District, Beijing, 100053, China.
Eur Spine J. 2020 Dec;29(12):3203-3213. doi: 10.1007/s00586-020-06515-3. Epub 2020 Jun 27.
Primary spinal cord glioblastoma (GBM) is a rare and devastating disease. Little attention was ever paid to this rare disease. As a result, the standard treatment protocol and prognostic factors of primary spinal cord GBM were not well established. The aim of this study was to determine the predictors associated with survival in patients with primary spinal cord GBM.
A total of 122 patients with primary spinal cord GBM from Surveillance, Epidemiology, and End Results database and our institution were included in this retrospective analysis. Information about age, sex, race, tumor invasion, extent of resection, radiation, chemotherapy and year of diagnosis was collected. Univariate and multivariate accelerated failure time (AFT) regression model was performed to identify prognostic factors.
Of the 122 patients, 102 (83.6%) expired at the time of data collection. Overall survival at 1 year, 2 years, 3 years and 5 years was 48.4%, 22.8%, 17.1% and 8.4%, respectively, and median survival time was 12 months. Only radiation was found to be associated with survival in the AFT regression model (time ratio 1.94, 95% CI 1.01-3.72, p < 0.05). Radiotherapy could improve survival slightly; patients who received RT survived approximately two times as long as patients who did not receive RT, but the advantage was short term.
The survival of primary spinal cord GBM is poor in the current treatment strategy. Radiotherapy was associated with better survival, but the advantage was short term.
原发性脊髓胶质母细胞瘤（GBM）是一种罕见且具有破坏性的疾病。由于对这种罕见疾病的关注甚少，因此尚未建立原发性脊髓 GBM 的标准治疗方案和预后因素。本研究旨在确定与原发性脊髓 GBM 患者生存相关的预测因素。
本回顾性分析纳入了来自监测、流行病学和最终结果数据库和我们机构的 122 名原发性脊髓 GBM 患者。收集了年龄、性别、种族、肿瘤侵袭、切除范围、放疗、化疗和诊断年份等信息。采用单变量和多变量加速失效时间（AFT）回归模型来确定预后因素。
在 122 名患者中，有 102 名（83.6%）在数据收集时已死亡。1 年、2 年、3 年和 5 年的总生存率分别为 48.4%、22.8%、17.1%和 8.4%，中位生存时间为 12 个月。仅放疗在 AFT 回归模型中与生存相关（时间比 1.94，95%CI 1.01-3.72，p<0.05）。放疗可略微改善生存；接受 RT 的患者的生存时间大约是未接受 RT 的患者的两倍，但这种优势是短期的。
在目前的治疗策略下，原发性脊髓 GBM 的生存状况较差。放疗与更好的生存相关，但优势是短期的。
