回顾性分析影响复发性胶质母细胞瘤患者复发时间的危险因素。
A retrospective analysis of the risk factors affecting recurrence time in patients with recurrent glioblastoma.
机构信息
Department of Nuclear Accident Medical Emergency, the Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Radiation Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Ann Palliat Med. 2021 May;10(5):5391-5399. doi: 10.21037/apm-21-823. Epub 2021 May 12.
BACKGROUND
This study explored the related factors that influence the recurrence time of glioblastomas (GBM).
METHODS
A retrospective study of recurrent GBM patients with surgical resection was performed. Recurrence time was analyzed using Kaplan-Meier survival curves. The Cox regression model was used to investigate the possible factors associated with recurrence time.
RESULTS
A total of 176 patients (113 males and 63 females) were enrolled in the study, with a median age of 57 years (range, 19-76 years). From this cohort, 18 patients (10.2%) had gross total resection (GTR), 53 patients (30.1%) had subtotal resection (STR), and 105 patients (59.7%) had partial resection (PR). Postoperatively, all patients received radiotherapy (RT), with 55.1% administered concurrent chemotherapy (CTh) and 59.7% administered adjuvant CTh. The median recurrence time was 10.0 months (range, 1.0-75.0 months). Patients with PR (P=0.004), gliomas that contacted the subventricular zone (SVZ) (P=0.004), isocitrate dehydrogenase 1 (IDH1) wild-type (P=0.048), telomerase reverse transcriptase (TERT) C228T wild-type (P=0.012), and positive glial fibrillary acidic protein (GFAP) expression (P=0.044) had a shortened time to recurrence. Cox regression analysis revealed that PR (P=0.036), SVZ contact (P=0.008), and TERT C228T wild type (P=0.023) were significantly associated with a shortened recurrence time.
CONCLUSIONS
PR, tumor contacting the SVZ, and TERT C228T wild type were independent risk factors for tumor recurrence in patients with GBM.
背景
本研究探讨了影响胶质母细胞瘤（GBM）复发时间的相关因素。
方法
对行手术切除的复发性 GBM 患者进行回顾性研究。采用 Kaplan-Meier 生存曲线分析复发时间。采用 Cox 回归模型探讨与复发时间相关的可能因素。
结果
共纳入 176 例患者（男性 113 例，女性 63 例），中位年龄 57 岁（19-76 岁）。该队列中，18 例（10.2%）行肿瘤全切除（GTR），53 例（30.1%）行次全切除（STR），105 例（59.7%）行部分切除（PR）。术后所有患者均接受放疗（RT），55.1%接受同期化疗（CTh），59.7%接受辅助 CTh。中位复发时间为 10.0 个月（1.0-75.0 个月）。PR（P=0.004）、肿瘤接触侧脑室下区（SVZ）（P=0.004）、异柠檬酸脱氢酶 1（IDH1）野生型（P=0.048）、端粒酶逆转录酶（TERT）C228T 野生型（P=0.012）和胶质纤维酸性蛋白（GFAP）阳性表达（P=0.044）的患者复发时间较短。Cox 回归分析显示，PR（P=0.036）、SVZ 接触（P=0.008）和 TERT C228T 野生型（P=0.023）与复发时间缩短显著相关。
结论
PR、肿瘤接触 SVZ 和 TERT C228T 野生型是 GBM 患者肿瘤复发的独立危险因素。
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