Napieralska Aleksandra, Krzywon Aleksandra, Mizia-Malarz Agnieszka, Sosna-Zielińska Joanna, Pawłowska Ewa, Krawczyk Małgorzata A, Konat-Bąska Katarzyna, Kaczorowska Aneta, Dąbrowska Anna, Harat Maciej
Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-101 Gliwice, Poland.
Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland.
Cancers (Basel). 2021 Apr 24;13(9):2062. doi: 10.3390/cancers13092062.
Due to the rarity of high-grade gliomas (HGG) in children, data on this topic are scarce. The study aimed to investigate the long-term results of treatment of children with HGG and to identify factors related to better survival. We performed a retrospective analysis of patients treated for HGG who had the main tumor located outside the brainstem. The evaluation of factors that correlated with better survival was performed with the Cox proportional-hazard model. Survival was estimated with the Kaplan-Meier method. The study group consisted of 82 consecutive patients. All of them underwent surgery as primary treatment. Chemotherapy was applied in 93% of children with one third treated with temozolomide. After or during the systemic treatment, 79% of them received radiotherapy with a median dose of 54 Gy. Median follow-up was 122 months, and during that time, 59 patients died. One-, 2-, 5-, and 10-year overall survival was 78%, 48%, 30% and 17%, respectively. Patients with radical (R0) resection and temozolomide-based chemotherapy had better overall survival. Progression-free survival was better in patients after R0 resection and radical radiotherapy. The best outcome in HGG patients was observed in patients after R0 resection with immediate postoperative temozolomide-based chemotherapy and radical radiotherapy.
由于儿童高级别胶质瘤（HGG）较为罕见，关于这一主题的数据稀缺。本研究旨在调查HGG患儿的长期治疗结果，并确定与更好生存相关的因素。我们对主要肿瘤位于脑干外的HGG治疗患者进行了回顾性分析。采用Cox比例风险模型对与更好生存相关的因素进行评估。采用Kaplan-Meier法估计生存率。研究组由82例连续患者组成。他们均接受手术作为主要治疗。93%的儿童接受了化疗，其中三分之一接受替莫唑胺治疗。在全身治疗后或治疗期间，79%的患者接受了放疗，中位剂量为54 Gy。中位随访时间为122个月，在此期间，59例患者死亡。1年、2年、5年和10年总生存率分别为78%、48%、30%和17%。接受根治性（R0）切除和基于替莫唑胺化疗的患者总生存率更高。R0切除和根治性放疗后的患者无进展生存期更好。HGG患者中，R0切除后立即接受基于替莫唑胺的化疗和根治性放疗的患者预后最佳。
