Chu Xiufeng, Zhang Ting, Benghiat Helen, Xu Jixuan
Department of Oncology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Marshall Medical Center, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2024 Dec 16;14:1442612. doi: 10.3389/fonc.2024.1442612. eCollection 2024.
Adult pineoblastoma is an extremely rare central nervous system malignancy. Limitations of tumour databases, single institution retrospective analyses and a few case reports are not sufficient to clarify treatment options. Therefore, a systematic review of comprehensive research data provides referenceable treatment options.
A systematic review was performed using MEDLINE and Embase using the terms "pineoblastoma" and "adult". Relevant articles in the references were considered to supplement this systematic review. In addition, data were analysed using Kaplan-Meier survival curves, COX analysis, chi-square tests and log-rank tests.
A total of 108 adult cases from 32 articles were included in this study and the median age at diagnosis was 30 years. The 5-year survival rate was 49.5% (95% confidence interval: 0.378-0.602) and the 10-year survival rate was 33.9% (95% confidence interval: 0.207-0.476). During the 10-year follow-up period, Kaplan-Meier survival curves highlighted that the gross total resection was more beneficial than subtotal resection and no surgery (P=0.018). The treatment modality of radiotherapy and chemotherapy was beneficial for survival (P<0.001; P=0.020). In addition, multivariate COX analysis showed that radiotherapy was an independent factor in the beneficial prognosis (P<0.001) and gross total resection tends to improve survival within five years (P=0.079).
For adult pineoblastoma, gross total excision and radiotherapy can be beneficial for survival.Systematic Review Registration: [website], identifier [registration number].
成人松果体母细胞瘤是一种极其罕见的中枢神经系统恶性肿瘤。肿瘤数据库的局限性、单机构回顾性分析以及少数病例报告不足以阐明治疗方案。因此,对综合研究数据进行系统评价可提供具有参考价值的治疗方案。
使用MEDLINE和Embase数据库,以“松果体母细胞瘤”和“成人”为检索词进行系统评价。参考文献中的相关文章也纳入本系统评价以作补充。此外,采用Kaplan-Meier生存曲线、COX分析、卡方检验和对数秩检验进行数据分析。
本研究共纳入32篇文章中的108例成人病例,诊断时的中位年龄为30岁。5年生存率为49.5%(95%置信区间:0.378 - 0.602),10年生存率为33.9%(95%置信区间:0.207 - 0.476)。在10年随访期内,Kaplan-Meier生存曲线显示,肿瘤全切除比次全切除和未手术更有益(P = 0.018)。放疗和化疗的治疗方式对生存有益(P < 0.001;P = 0.020)。此外,多因素COX分析显示放疗是预后良好的独立因素(P < 0.001),肿瘤全切除倾向于提高5年内的生存率(P = 0.079)。
对于成人松果体母细胞瘤,肿瘤全切除和放疗对生存可能有益。系统评价注册:[网站],标识符[注册号]。