肿瘤治疗电场治疗新诊断胶质母细胞瘤的18年经验。
Eighteen years' experience with tumor treating fields in the treatment of newly diagnosed glioblastoma.
作者信息
Vymazal Josef, Kazda Tomas, Novak Tomas, Slanina Petr, Sroubek Jan, Klener Jan, Hrbac Tomas, Syrucek Martin, Rulseh Aaron M
机构信息
Department of Radiology and Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czechia.
Department of Radiation Oncology, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czechia.
出版信息
Front Oncol. 2023 Jan 19;12:1014455. doi: 10.3389/fonc.2022.1014455. eCollection 2022.
INTRODUCTION
The prognosis of glioblastoma remains unfavorable. TTFields utilize low intensity electric fields (frequency 150-300 kHz) that disrupt cellular processes critical for cancer cell viability and tumor progression. TTFields are delivered via transducer arrays placed on the patients' scalp. Methods: Between the years 2004 and 2022, 55 patients (20 female), aged 21.9-77.8 years (mean age 47.3±11.8 years; median 47.6 years) were treated with TTFields for newly-diagnosed GBM, and compared to 54 control patients (20 females), aged 27.0-76.7 years (mean age 51.4±12.2 years; median 51.7 years) (p=0.08). All patients underwent gross total or partial resection of GBM. One patient had biopsy only. When available, MGMT promoter methylation status and IDH mutation was detected.
RESULTS
Patients on TTFields therapy demonstrated improvements in PFS and OS relative to controls (hazard ratio: 0.64, p=0.031; and 0.61, p=0.028 respectively). TTFields average time on therapy was 74.8% (median 82%): median PFS of these patients was 19.75 months. Seven patients with TTFields usage ≤60% (23-60%, mean 46.3%, median 53%) had a median PFS of 7.95 months (p=0.0356). Control patients with no TTFields exposure had a median PFS of 12.45 months. Median OS of TTF patients was 31.67 months compared to 24.80 months for controls.
DISCUSSION
This is the most extensive study on newly-diagnosed GBM patients treated with TTFields, covering a period of 18 years at a single center and presenting not only data from clinical trials but also a group of 36 patients treated with TTFields as a part of routine clinical practice.
引言
胶质母细胞瘤的预后仍然不容乐观。肿瘤治疗电场(TTFields)利用低强度电场(频率150 - 300千赫兹)来扰乱对癌细胞生存能力和肿瘤进展至关重要的细胞过程。TTFields通过放置在患者头皮上的换能器阵列进行传递。方法:在2004年至2022年期间,55例(20例女性)年龄在21.9 - 77.8岁(平均年龄47.3±11.8岁;中位数47.6岁)的新诊断胶质母细胞瘤患者接受了TTFields治疗,并与54例对照患者(20例女性)进行比较,对照患者年龄在27.0 - 76.7岁(平均年龄51.4±12.2岁;中位数51.7岁)(p = 0.08)。所有患者均接受了胶质母细胞瘤的大体全切或部分切除。仅1例患者进行了活检。如有可能,检测了MGMT启动子甲基化状态和异柠檬酸脱氢酶(IDH)突变。
结果
与对照组相比,接受TTFields治疗的患者在无进展生存期(PFS)和总生存期(OS)方面有改善(风险比分别为:0.64,p = 0.031;和0.61,p = 0.028)。TTFields的平均治疗时间为74.8%(中位数82%):这些患者的中位PFS为19.75个月。7例TTFields使用时间≤60%(23 - 60%,平均46.3%,中位数53%)的患者中位PFS为7.95个月(p = 0.0356)。未接受TTFields治疗的对照患者中位PFS为12.45个月。接受TTFields治疗患者的中位OS为31.67个月,而对照组为24.80个月。
讨论
这是关于新诊断胶质母细胞瘤患者接受TTFields治疗的最广泛研究,涵盖了单个中心18年的时间,不仅展示了临床试验数据,还包括作为常规临床实践一部分接受TTFields治疗的36例患者群体。