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多模态术中应用可改善成人胶质母细胞瘤的预后:一项单中心观察性研究。

The Intraoperative Utilization of Multimodalities Could Improve the Prognosis of Adult Glioblastoma: A Single-Center Observational Study.

机构信息

Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China; Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China.

Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

出版信息

World Neurosurg. 2022 Sep;165:e532-e545. doi: 10.1016/j.wneu.2022.06.094. Epub 2022 Jun 26.

Abstract

OBJECTIVE

In recent years, numerous neurosurgical multimodal techniques have been utilized to maximize tumor resection safely and effectively. However, the synergetic effects of neurosurgical multimodalities on the survival of glioblastoma patients remain unclear. This study evaluated the role of intraoperative utilization of multimodalities in glioblastoma patients.

METHODS

Data of 912 adult patients with glioblastoma were obtained from the Huashan Glioma Registry. The utilization of fewer than 2 (multimodality value < 2) intraoperative multimodal techniques was defined as the nonmultimodal group. In contrast, the utilization of 2 or more (multimodality value ≥ 2) intraoperative multimodal techniques was regarded as the multimodal group. The prognosis of the 2 cohorts was compared and further stratified based on the diagnosis date (2010-2014 or 2015-2019) to reveal the role of the application of multimodal techniques.

RESULTS

The median overall survival (OS) and progression-free survival of glioblastoma patients were 17.70 months and 12.03 months, respectively. The OS time of the multimodal group was noticeably longer than that of the nonmultimodal group (21.0 months vs. 16.0 months, P < 0.001). Multimodal techniques were more frequently applied in surgery in the 2015-2019 group than in the 2010-2014 group. The popularity of multimodal techniques contributed to significant improvement in the prognosis of glioblastoma patients from 2010-2014 to 2015-2019 (OS, 16.0 months vs. 22.0 months, P < 0.001).

CONCLUSIONS

This study indicated that the utilization of intraoperative multimodal techniques improved the extent of resection and elevated the survival for adult glioblastoma patients.

摘要

目的

近年来,许多神经外科多模态技术被用于安全有效地最大限度地切除肿瘤。然而,神经外科多模态技术对胶质母细胞瘤患者生存的协同作用尚不清楚。本研究评估了术中多模态技术在胶质母细胞瘤患者中的作用。

方法

从华山神经胶质瘤注册中心获得了 912 名成人胶质母细胞瘤患者的数据。术中使用少于 2 种(多模态值<2)多模态技术定义为非多模态组。相比之下,使用 2 种或更多种(多模态值≥2)多模态技术被认为是多模态组。比较了这两组的预后,并根据诊断日期(2010-2014 年或 2015-2019 年)进一步分层,以揭示多模态技术应用的作用。

结果

胶质母细胞瘤患者的中位总生存期(OS)和无进展生存期分别为 17.70 个月和 12.03 个月。多模态组的 OS 时间明显长于非多模态组(21.0 个月 vs. 16.0 个月,P<0.001)。2015-2019 年组中多模态技术在手术中应用更为频繁。多模态技术的普及显著改善了 2010-2014 年至 2015-2019 年胶质母细胞瘤患者的预后(OS,16.0 个月 vs. 22.0 个月,P<0.001)。

结论

本研究表明,术中多模态技术的应用提高了成人胶质母细胞瘤患者的切除范围,提高了生存率。

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