Harrup Rosemary, White Victoria M, Coory Michael, Walker Rick, Anazodo Antoinette, Skaczkowski Gemma, Bibby Helen, Osborn Michael, Phillips Marianne B, Conyers Rachel, Thompson Kate, Orme Lisa M, Pinkerton Ross, Nicholls Wayne
Medical Oncology/Haematology, Royal Hobart Hospital, Tasmania, Australia.
School of Psychology, Deakin University, Victoria, Australia.
J Adolesc Young Adult Oncol. 2021 Apr;10(2):202-208. doi: 10.1089/jayao.2020.0074. Epub 2020 Aug 26.
While central nervous system (CNS) tumors account for only 10% of adolescent and young adult (AYA) cancers, they are the leading cause of cancer death in this age group. Using national data for Australia, we describe the presentation, treatment, and survival for AYAs diagnosed with CNS tumors. A population-based study of 15-24 year-olds diagnosed with CNS tumors (low- and high-grade glioma [LGG, HGG], medulloblastoma [MB], primitive neuroectodermal tumors [PNET], ependymoma [EP]) or other (e.g., low-grade neuronal tumor) between 2007 and 2012. Clinical details were extracted from hospital medical records for each patient. Treatment centers were classified as pediatric or adult services. Two hundred seventy-five patients (129 LGG, 77 HGG, 23 MB, 10 PNET, 19 EP, 17 other) were identified, with 17% treated at pediatric hospitals. Symptoms (headache [53%], nausea [31%]) were present for a median of 3 weeks before consulting a health professional. Of LGG patients, 15% had radiotherapy (RT) and 12% chemotherapy (CT). Of HGG patients, 81% had RT and 75% CT. All MB and PNET were managed with surgery, and 74% of MB and 80% of PNET had both RT and CT. Treatment did not differ by treatment center type. Five-year survival for LGG and EP was over 80%, but was 42% for HGG and 20% for PNET. This national, population-based study indicates similar treatment for AYA patients with CNS tumors between pediatric and adult services. Poor outcomes for HGG and PNET patients highlight the need for clinical trials of novel approaches for these tumors.
虽然中枢神经系统（CNS）肿瘤仅占青少年和青年（AYA）癌症的10%，但却是该年龄组癌症死亡的主要原因。利用澳大利亚的全国数据，我们描述了被诊断为中枢神经系统肿瘤的青少年和青年的临床表现、治疗情况及生存状况。对2007年至2012年间被诊断为中枢神经系统肿瘤（低级别和高级别胶质瘤[LGG、HGG]、髓母细胞瘤[MB]、原始神经外胚层肿瘤[PNET]、室管膜瘤[EP]）或其他（如低级别神经元肿瘤）的15至24岁人群进行了一项基于人群的研究。从每位患者的医院病历中提取临床细节。治疗中心分为儿科或成人服务机构。共确定了275名患者（129例LGG、77例HGG、23例MB、10例PNET、19例EP、17例其他），其中17%在儿科医院接受治疗。在咨询医疗专业人员之前，症状（头痛[53%]、恶心[31%]）出现的中位时间为3周。LGG患者中，15%接受了放疗（RT），12%接受了化疗（CT）。HGG患者中，81%接受了RT，75%接受了CT。所有MB和PNET均通过手术治疗，74%的MB和80%的PNET同时接受了RT和CT。治疗情况在不同类型的治疗中心之间没有差异。LGG和EP的五年生存率超过80%，但HGG为42%，PNET为20%。这项基于全国人群的研究表明，儿科和成人服务机构对患有中枢神经系统肿瘤的青少年和青年患者的治疗相似。HGG和PNET患者的不良预后凸显了针对这些肿瘤开展新方法临床试验的必要性。
