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1型神经纤维瘤病胶质母细胞瘤患者的10年生存率:病例说明

Ten-year survival in glioblastoma patient with neurofibromatosis type 1: illustrative case.

作者信息

Basindwah Sarah, Alkhalidi Hisham, Abdelwarith Ahmed, Elwatidy Sherif

机构信息

1Department of Surgery, Division of Neurosurgery.

2Department of Pathology, and.

出版信息

J Neurosurg Case Lessons. 2022 Jan 24;3(4). doi: 10.3171/CASE21630.

Abstract

BACKGROUND

Gliomas are commonly detected in patients with neurofibromatosis type 1 (NF1) at an early age. Few patients with NF1 are diagnosed with glioblastoma. The course of management, response to therapy, and prognosis of such patients are unknown. Few reports have shown longer-than-average survival rates for patients with NF1 with glioblastoma.

OBSERVATIONS

A 27-year-old man with NF1 presented with symptoms of high intracranial pressure. Imaging and pathology showed left frontotemporal glioblastoma. Gross total resection was achieved, and concurrent chemoradiotherapy was administered. Recurrence of tumor was detected 48 months later, and the patient underwent tumor debulking and concurrent chemoradiotherapy. The patient received first-, second-, and third-line chemotherapy (temozolomide, bevacizumab, bevacizumab/irinotecan) with good tolerance and has survived >10 years since then with good functional status.

LESSONS

This case demonstrates >10 years overall survival of glioblastoma in a patient with NF1. Reports of patients with NF1 with longer survival may be attributed to the young age at diagnosis and relatively better tolerance for therapy. It might also support the growing evidence of a unique subset of glioblastoma associated with NF1 and opens the door for a more molecular targeted therapy in the future.

摘要

背景

神经纤维瘤病1型(NF1)患者通常在幼年时就被检测出患有胶质瘤。很少有NF1患者被诊断为胶质母细胞瘤。此类患者的治疗过程、对治疗的反应及预后尚不清楚。少数报告显示,NF1合并胶质母细胞瘤患者的生存率高于平均水平。

观察结果

一名27岁的NF1男性患者出现颅内压增高症状。影像学和病理学检查显示为左额颞叶胶质母细胞瘤。实现了肿瘤全切,并进行了同步放化疗。48个月后检测到肿瘤复发,患者接受了肿瘤减瘤手术及同步放化疗。患者接受了一线、二线和三线化疗(替莫唑胺、贝伐单抗、贝伐单抗/伊立替康),耐受性良好,自那时起已存活超过10年,功能状态良好。

经验教训

该病例显示一名NF1患者的胶质母细胞瘤总体生存期超过10年。NF1患者生存期较长的报告可能归因于诊断时年龄较轻以及对治疗相对较好的耐受性。这也可能支持越来越多的证据表明存在与NF1相关的独特胶质母细胞瘤亚群,并为未来更具分子靶向性的治疗打开了大门。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9488/9379713/3a49caf05791/CASE21630f1.jpg

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