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髓母细胞瘤患者生存的危险因素：一项系统评价和荟萃分析。

Risk Factors for Survival in Patients With Medulloblastoma: A Systematic Review and Meta-Analysis.

作者信息

Liu Yu, Xiao Bo, Li Sen, Liu Jiangang

机构信息

Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Oncol. 2022 Mar 3;12:827054. doi: 10.3389/fonc.2022.827054. eCollection 2022.

DOI:10.3389/fonc.2022.827054
PMID:35311074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8927734/
Abstract

BACKGROUND

Conventional parameters show limited and unreliable correlations with medulloblastoma prognosis.

AIM

To evaluate the factors influencing overall survival (OS), event-free survival (EFS), and progression-free survival (PFS) in patients with medulloblastoma.

METHODS

PubMed, EMBASE, the Cochrane Library, and Web of Science were searched for studies published up to May 2021. The associations between various clinical and treatment factors and survival parameters were assessed.

RESULTS

Twenty-nine studies (8455 patients) were included. Desmoplastic medulloblastoma (HR=0.41, 95%CI: 0.31-0.56), M0 disease (HR=2.07, 95%CI: 1.48-2.89), WNT, SSH, group 4 (all P<0.05 vs. group 3), GTR vs. STR (HR=1.37, 95%CI: 1.04-1.08), radiotherapy (HR=0.45, 95%CI: 0.20-0.80), craniospinal irradiation (HR=0.49, 95%CI: 0.38-0.64), and high 5hmC levels (HR=2.90, 95%CI: 1.85-4.55) were associated with a better OS. WNT, SSH, group 4 (all P<0.05 vs. group 3), residual tumor ≤1.5 cm (HR=2.08, 95%CI: 1.18-3.68), GTR vs. STR (HR=1.31, 95%CI: 1.03-1.68), craniospinal irradiation (HR=0.46, 95%CI: 0.37-0.57), high 5hmC levels (HR=3.10, 95%CI: 2.01-4.76), and <49 days between resection and radiotherapy (HR=2.54, 95%CI: 1.48-4.37) were associated with better PFS. Classic vs. desmoplastic medulloblastoma (HR=1.81, 95%CI: 1.04-3.16), SSH, WNT (both P<0.05 vs, non-SSH/non-WNT), GTR vs. STR (HR=2.01, 95%CI: 1.42-2.85), and radiotherapy (HR=0.31, 95%CI: 0.15-0.64) were associated with a better EFS.

CONCLUSION

Histology, molecular subgroup, GTR, and radiotherapy are significantly associated with survival parameters in patients with medulloblastoma. Nevertheless, high-quality prospective cohort studies are necessary to improve the conclusions.

摘要

背景

传统参数与髓母细胞瘤预后的相关性有限且不可靠。

目的

评估影响髓母细胞瘤患者总生存期（OS）、无事件生存期（EFS）和无进展生存期（PFS）的因素。

方法

检索PubMed、EMBASE、Cochrane图书馆和Web of Science，查找截至2021年5月发表的研究。评估各种临床和治疗因素与生存参数之间的关联。

结果

纳入29项研究（8455例患者）。促纤维增生型髓母细胞瘤（HR = 0.41，95%CI：0.31 - 0.56）、M0期疾病（HR = 2.07，95%CI：1.48 - 2.89）、WNT、SSH、4组（与3组相比，所有P < 0.05）、全切（GTR）与次全切（STR）（HR = 1.37，95%CI：1.04 - 1.08）、放疗（HR = 0.45，95%CI：0.20 - 0.80）、全脑脊髓照射（HR = 0.49，95%CI：0.38 - 0.64）以及高5hmC水平（HR = 2.90，95%CI：1.85 - 4.55）与更好的总生存期相关。WNT、SSH、4组（与3组相比，所有P < 0.05）、残留肿瘤≤1.5 cm（HR = 2.08，95%CI：1.18 - 3.68）、全切与次全切（HR = 1.31，95%CI：1.03 - 1.68）、全脑脊髓照射（HR = 0.46，95%CI：0.37 - 0.57）、高5hmC水平（HR = 3.10，95%CI：2.01 - 4.76）以及切除与放疗间隔<49天（HR = 2.54，95%CI：1.48 - 4.37）与更好的无进展生存期相关。经典型与促纤维增生型髓母细胞瘤（HR = 1.81，95%CI：1.04 - 3.16）、SSH、WNT（与非SSH/非WNT相比，两者P < 0.05）、全切与次全切（HR = 2.01，95%CI：1.42 - 2.85）以及放疗（HR = 0.31，95%CI：0.15 - 0.64）与更好的无事件生存期相关。

结论

组织学、分子亚组、全切和放疗与髓母细胞瘤患者的生存参数显著相关。然而，需要高质量的前瞻性队列研究来完善这些结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/d0d6c4912b1b/fonc-12-827054-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/ed04c1fdfa4c/fonc-12-827054-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/3292e4d1029c/fonc-12-827054-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/fa0579c2195e/fonc-12-827054-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/d0d6c4912b1b/fonc-12-827054-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/ed04c1fdfa4c/fonc-12-827054-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/3292e4d1029c/fonc-12-827054-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/fa0579c2195e/fonc-12-827054-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0295/8927734/d0d6c4912b1b/fonc-12-827054-g004.jpg

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