Department of Radiation Oncology, Unicancer, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, BP 23025, 67033 Strasbourg, France.
Department of Neurosurgery, CHU de Hautepierre, 1, rue Molière, 67200 Strasbourg, France.
Cancer Radiother. 2024 Aug;28(4):365-372. doi: 10.1016/j.canrad.2024.03.003. Epub 2024 Aug 1.
Neurocytomas represent 0.25 to 0.5% of primary brain tumours and are mainly found in young adults. These tumours have neuronal differentiation. The cornerstone treatment is neurosurgery. The efficacy of other therapies, including radiotherapy, is still unclear. The objective of this study was to evaluate the management of central neurocytomas and the role of radiotherapy.
All adult patients (age 18 years or older) newly diagnosed with a histologically confirmed neurocytoma between 2006 and 2015 in France were included.
One hundred and sixteen patients were diagnosed with a central neurocytoma during the study period. All patients underwent surgical resection, and six received adjuvant radiotherapy. Eleven patients received radiotherapy due to progression. After a median follow-up of 68.7 months, local failure occurred in 29 patients. The 5-year local control rate was 73.4%. According to univariate analysis, marker of proliferation Ki67 index greater than 2% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.40-1.57; P=0.027) and subtotal resection (HR: 8.48; CI: 8.01-8.99; P<0.001) were associated with an increase in local failure. Gross total resection was associated with a higher risk of sequelae epilepsy (HR: 3.62; CI: 3.42-3.83; P<0.01) and memory disorders (HR: 1.35; CI: 1.07-1.20; P<0.01). Ten patients (8.6%) died during the follow-up. The 10-year overall survival rate was 89.0%. No prognostic factors for overall survival were found.
The analysis showed that patients who underwent subtotal surgical resection, particularly when the tumour had a Ki67 index greater than 2%, had an increased risk of local recurrence. These patients could benefit from adjuvant radiotherapy.
神经细胞瘤占原发性脑肿瘤的 0.25%至 0.5%,主要发生在年轻成人中。这些肿瘤具有神经元分化。主要治疗方法是神经外科手术。其他治疗方法(包括放疗)的疗效尚不清楚。本研究的目的是评估中枢神经细胞瘤的治疗方法和放疗的作用。
本研究纳入了 2006 年至 2015 年间在法国新诊断为组织学证实的神经细胞瘤的所有成年患者(年龄 18 岁或以上)。
在研究期间,共有 116 例患者被诊断为中枢神经细胞瘤。所有患者均接受了手术切除,其中 6 例接受了辅助放疗。11 例患者因进展而接受放疗。中位随访 68.7 个月后,29 例患者发生局部复发。5 年局部控制率为 73.4%。单因素分析显示,增殖标志物 Ki67 指数大于 2%(风险比 [HR]:1.48;置信区间 [CI]:1.40-1.57;P=0.027)和次全切除(HR:8.48;CI:8.01-8.99;P<0.001)与局部复发风险增加相关。大体全切除与继发癫痫(HR:3.62;CI:3.42-3.83;P<0.01)和记忆障碍(HR:1.35;CI:1.07-1.20;P<0.01)的风险增加相关。10 例(8.6%)患者在随访期间死亡。10 年总生存率为 89.0%。未发现总生存的预后因素。
分析表明,接受次全外科切除的患者,特别是肿瘤 Ki67 指数大于 2%的患者,局部复发风险增加。这些患者可能受益于辅助放疗。