Li Shan, Zhao Yanjie, Huang Hongyan
Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2024 May 3;103(18):e37910. doi: 10.1097/MD.0000000000037910.
To illustrate the clinical characteristics and prognostic factors of adult patients pathologically confirmed with brainstem gliomas (BSGs). Clinical data of 40 adult patients pathologically diagnosed with BSGs admitted to Beijing Shijitan Hospital from 2009 to 2022 were recorded and retrospectively analyzed. The primary parameters included relevant symptoms, duration of symptoms, Karnofsky performance status (KPS), tumor location, type of surgical resection, diagnosis, treatment, and survival. Univariate and multivariate analyses were evaluated by Cox regression models. The gliomas were located in the midbrain of 9 patients, in the pons of 14 cases, in the medulla of 5 cases, in the midbrain and pons of 6 cases and invading the medulla and pons of 6 cases, respectively. The proportion of patients with low-grade BSGs was 42.5%. Relevant symptoms consisted of visual disturbance, facial paralysis, dizziness, extremity weakness, ataxia, paresthesia, headache, bucking, dysphagia, dysacousia, nausea, dysphasia, dysosmia, hypomnesia and nystagmus. 23 (57.5%) patients accepted stereotactic biopsy, 17 (42.5%) patients underwent surgical resection. 39 patients received radiotherapy and 34 cases were treated with temozolomide. The median overall survival (OS) of all patients was 26.2 months and 21.5 months for the median progression-free survival (PFS). Both duration of symptoms (P = .007) and tumor grading (P = .002) were the influencing factors for OS, and tumor grading was significantly associated with PFS (P = .001). Duration of symptoms for more than 2 months and low-grade are favorable prognostic factors for adult patients with BSGs.
阐述经病理确诊的成年脑干胶质瘤（BSG）患者的临床特征及预后因素。记录并回顾性分析2009年至2022年在北京世纪坛医院收治的40例经病理诊断为BSG的成年患者的临床资料。主要参数包括相关症状、症状持续时间、卡氏功能状态评分（KPS）、肿瘤位置、手术切除类型、诊断、治疗及生存情况。通过Cox回归模型进行单因素和多因素分析。胶质瘤位于中脑9例，脑桥14例，延髓5例，中脑和脑桥6例，侵犯延髓和脑桥6例。低级别BSG患者比例为42.5%。相关症状包括视力障碍、面瘫、头晕、肢体无力、共济失调、感觉异常、头痛、呕吐、吞咽困难、听力障碍、恶心、言语障碍、嗅觉障碍、记忆力减退和眼球震颤。23例（57.5%）患者接受立体定向活检，17例（42.5%）患者接受手术切除。39例患者接受放疗，34例患者接受替莫唑胺治疗。所有患者的中位总生存期（OS）为26.2个月，中位无进展生存期（PFS）为21.5个月。症状持续时间（P = .007）和肿瘤分级（P = .002）均为OS的影响因素，肿瘤分级与PFS显著相关（P = .001）。症状持续时间超过2个月及低级别是成年BSG患者的有利预后因素。
