Nelson D F, Nelson J S, Davis D R, Chang C H, Griffin T W, Pajak T F
J Neurooncol. 1985;3(2):99-103. doi: 10.1007/BF02228884.
This study confirms the importance of histologic tumor necrosis as a major prognostic variable in malignant glioma. Necrosis is present in glioblastoma multiforme (GBM), and absent in astrocytoma with atypical or anaplastic features (AAF). This paper evaluates 94 patients with AAF and 462 patients with GBM treated with radiation therapy with or without BCNU on 3 consecutive randomized protocols of the Radiation Therapy Oncology Group (RTOG) between 1974 and 1983. Multivariate analyses of the 556 patients confirmed histology as a significant independent variable that is prognostically relatively more important than Karnofsky performance status (KPS) and extent of surgery, and somewhat less important than age. The median survival for AAF was 36.2 months and for GBM was 8.6 months. In addition, separate multivariate analyses of AAf cases determined that the extent of surgery is a significant independent variable that is relatively more important than KPS, but less important than age. The median survival of AAF patients who underwent surgical excision was 46.8 months compared with 15.2 months for those biopsied (p less than .001).
本研究证实了组织学肿瘤坏死作为恶性胶质瘤主要预后变量的重要性。坏死存在于多形性胶质母细胞瘤（GBM）中，而在具有非典型或间变性特征（AAF）的星形细胞瘤中不存在。本文评估了1974年至1983年间在放射治疗肿瘤学组（RTOG）的3个连续随机方案中接受放疗（有或无卡氮芥）治疗的94例AAF患者和462例GBM患者。对这556例患者的多变量分析证实，组织学是一个显著的独立变量，在预后方面相对比卡氏功能状态（KPS）和手术范围更重要，且比年龄稍次要。AAF的中位生存期为36.2个月，GBM为8.6个月。此外，对AAF病例的单独多变量分析确定，手术范围是一个显著的独立变量，相对比KPS更重要，但比年龄次要。接受手术切除的AAF患者的中位生存期为46.8个月，而接受活检的患者为15.2个月（p小于0.001）。
