Brown Nicholas F, Ottaviani Diego, Tazare John, Gregson John, Kitchen Neil, Brandner Sebastian, Fersht Naomi, Mulholland Paul
Department of Oncology, University College London Hospitals, London NW1 2PG, UK.
UCL Cancer Institute, University College London, London WC1E 6DD, UK.
Cancers (Basel). 2022 Jun 28;14(13):3161. doi: 10.3390/cancers14133161.
Background: IDH-wildtype glioblastoma is the most common malignant primary brain tumour in adults. As there is limited information on prognostic factors outside of clinical trials; thus, we conducted a retrospective study to characterise the glioblastoma population at our centre. Methods: Demographic, tumour molecular profiles, treatment, and survival data were collated for patients diagnosed with glioblastoma at our centre between July 2011 and December 2015. We used multivariate proportional hazard model associations with survival. Results: 490 patients were included; 60% had debulking surgery and 40% biopsy only. Subsequently, 56% had standard chemoradiotherapy, 25% had non-standard chemo/radio-therapy, and 19% had no further treatment. Overall survival was 9.2 months. In the multivariate analysis, longer survival was associated with debulking surgery vs. biopsy alone (14.9 vs. 8 months) (HR 0.54 [95% CI 0.41−0.70]), subsequent treatment after diagnosis (HR 0.12 [0.08−0.16]) (standard chemoradiotherapy [16.9 months] vs. non-standard regimens [9.2 months] vs. none [2.0 months]), tumour MGMT promotor methylation (HR 0.71 [0.58−0.87]), and younger age (hazard ratio vs. age < 50: 1.70 [1.26−2.30] for ages 50−59; 3.53 [2.65−4.70] for ages 60−69; 4.82 [3.54−6.56] for ages 70+). Conclusions: The median survival for patients with glioblastoma is less than a year. Younger age, debulking surgery, treatment with chemoradiotherapy, and MGMT promotor methylation are independently associated with longer survival.
异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤是成人中最常见的原发性恶性脑肿瘤。由于临床试验之外关于预后因素的信息有限，因此，我们进行了一项回顾性研究，以描述我们中心胶质母细胞瘤患者群体的特征。方法：整理了2011年7月至2015年12月期间在我们中心被诊断为胶质母细胞瘤的患者的人口统计学、肿瘤分子特征、治疗和生存数据。我们使用多变量比例风险模型分析与生存的相关性。结果：纳入了490例患者；60%接受了肿瘤切除手术，40%仅接受了活检。随后，56%接受了标准放化疗，25%接受了非标准化疗/放疗，19%未接受进一步治疗。总生存期为9.2个月。在多变量分析中，生存期较长与肿瘤切除手术而非单纯活检相关（14.9个月对8个月）（风险比0.54 [95%置信区间0.41 - 0.70]），诊断后的后续治疗（风险比0.12 [0.08 - 0.16]）（标准放化疗[16.9个月]对非标准方案[9.2个月]对未治疗[2.0个月]），肿瘤O6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）启动子甲基化（风险比0.71 [0.58 - 0.87]），以及较年轻的年龄（年龄<50岁相比的风险比：50 - 59岁为1.70 [1.26 - 2.30]；60 - 69岁为3.53 [2.65 - 4.70]；70岁及以上为4.82 [3.54 - 6.56]）。结论：胶质母细胞瘤患者的中位生存期不到一年。较年轻的年龄、肿瘤切除手术、放化疗治疗以及MGMT启动子甲基化与较长生存期独立相关。
