Zhang Jin, Shen Hui, Yang Yibo, Mei Qing, Liu Jiachun, Liu Aihua
Department of Neurosurgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100000, China.
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing Tiantan Hospital, Beijing, 100070, China.
Neurosurg Rev. 2025 May 2;48(1):399. doi: 10.1007/s10143-025-03552-8.
Gliomatosis Cerebri (GC) is a rare and aggressively infiltrative diffuse glioma with a grim prognosis. The efficacy of chemotherapy in GC is controversial. This study aimed to assess the impact of chemotherapy on GC patients in a population-based cohort. Patients with Gliomatosis Cerebri (GC) diagnosed between 2000 and 2021 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curves were utilized and compared using the log-rank test to assess survival disparities. Cox regression analysis was employed to identify prognostic factors, with the results of the multivariate analysis presented in a forest plot. Subgroup analyses were then performed to discern which patient subgroups might potentially benefit from chemotherapy. Our cohort comprised 227 GC patients, with median cause-specific survival (CSS) was 11 months (95% Confidence Interval [CI],9-16 months) and a 5-year survival rate of 12.8%. Restrictive cubic splines (RCS) regression analysis indicated a significant linear correlation between advancing age and CSS (P < 0.001, P = 0.590). Multivariate Cox regression confirmed pediatric, primary site and chemotherapy treatment were prognostic factors for GC patients. Additionally, chemotherapy was linked to improved survival in patients who underwent surgery (HR = 0.50; 95% CI: 0.26-0.94) and radiotherapy (HR = 0.47; 95% CI: 0.28-0.82). Chemotherapy may contribute to improved prognosis for patients with GC, especially in those who have undergone surgery or radiotherapy, suggesting that these subgroups should be considered for additional chemotherapy. Nevertheless, prospective studies are warranted to substantiate these observations.
大脑胶质瘤病（GC）是一种罕见的、具有侵袭性浸润性的弥漫性胶质瘤，预后较差。化疗在GC中的疗效存在争议。本研究旨在评估化疗对基于人群队列中的GC患者的影响。从监测、流行病学和最终结果（SEER）数据库中识别出2000年至2021年间诊断为大脑胶质瘤病（GC）的患者。利用Kaplan-Meier生存曲线并使用对数秩检验进行比较，以评估生存差异。采用Cox回归分析来确定预后因素，多变量分析结果以森林图呈现。然后进行亚组分析，以辨别哪些患者亚组可能从化疗中潜在获益。我们的队列包括227例GC患者，中位特定病因生存率（CSS）为11个月（95%置信区间[CI]，9 - 16个月），5年生存率为12.8%。限制性立方样条（RCS）回归分析表明年龄增长与CSS之间存在显著线性相关性（P < 0.001，P = 0.590）。多变量Cox回归证实儿童、原发部位和化疗治疗是GC患者的预后因素。此外，化疗与接受手术患者的生存改善相关（HR = 0.50；95% CI：0.26 - 0.94）以及与接受放疗患者的生存改善相关（HR = 0.47；95% CI：0.28 - 0.82）。化疗可能有助于改善GC患者的预后，特别是在那些接受过手术或放疗的患者中，这表明这些亚组应考虑接受额外化疗。然而，需要进行前瞻性研究来证实这些观察结果。
