2016年后诊断为胶质母细胞瘤患者的生存获益有限：一项基于监测、流行病学和最终结果（SEER）数据库人群的登记分析

Limited survival benefit in patients diagnosed with glioblastoma post-2016: a SEER population based registry analysis.

作者信息

Dhingra Shaurya, Koshy Matthew, Korpics Mark

机构信息

Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, 1801 West Taylor Street, OCC C400, Chicago, IL, 60612, USA.

出版信息

J Cancer Res Clin Oncol. 2025 Jun 2;151(6):179. doi: 10.1007/s00432-025-06171-4.

DOI:10.1007/s00432-025-06171-4

PMID:40455099

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12130152/

Abstract

BACKGROUND

The EF14 clinical trial reported an improvement in median overall survival (OS) from 16.0 months to 20.9 months in patients with glioblastoma (GBM) who received treatment with tumor treating fields (TTFs). This study evaluates overall survival in a large population-based cohort of patients with GBM before and after FDA approval of TTFs in 2015.

METHODS

A total of 27,534 patients from the Surveillance, Epidemiology and End Results (SEER) database with GBM who underwent surgery and post-operative radiotherapy were grouped into three diagnosis periods: those diagnosed pre-temozolomide (2000-2004), those diagnosed post-temozolomide (2005-2015), and those diagnosed post-TTFs (2016-2020). Overall survival (OS) was calculated using the Kaplan-Meier method, and multivariate Cox regression models were employed to estimate hazard ratios (HR).

RESULTS

GBM diagnosis in the post-TTFs period was associated with a median OS of 15 months (95% CI 14-15 months) compared to a median OS of 14 months (95% CI 14-14 months, p < 0.001) for GBM diagnosis in the post-temozolomide/pre-TTFs period. 24-months OS was 25.6% (95% CI 24.5-26.8%) in the post-TTFs period and 24.7% (95% CI 24.0-25.4%) in the post-temozolomide/pre-TTFs period. In a multivariate model accounting for clinical characteristics, diagnosis in the post-TTFs period as compared to the post-temozolomide/pre-TTFs period was significantly associated with OS (HR: 0.941, 95% CI 0.912-0.972, p < 0.001).

CONCLUSION

This population-based cohort demonstrated minimal change in survival for patients diagnosed with GBM before and after FDA approval of TTFs in 2015.

摘要

背景

EF14临床试验报告称，接受肿瘤治疗电场（TTFs）治疗的胶质母细胞瘤（GBM）患者的中位总生存期（OS）从16.0个月提高到了20.9个月。本研究评估了2015年美国食品药品监督管理局（FDA）批准TTFs前后，一个基于大人群的GBM患者队列的总生存期。

方法

从监测、流行病学和最终结果（SEER）数据库中选取了27534例接受了手术及术后放疗的GBM患者，分为三个诊断时期：在替莫唑胺之前诊断的患者（2000 - 2004年）、在替莫唑胺之后诊断的患者（2005 - 2015年）以及在TTFs之后诊断的患者（2016 - 2020年）。使用Kaplan - Meier方法计算总生存期（OS），并采用多变量Cox回归模型估计风险比（HR）。

结果

与替莫唑胺之后/TTFs之前诊断的GBM患者中位OS为14个月（95%置信区间14 - 14个月）相比，TTFs之后诊断的GBM患者中位OS为15个月（95%置信区间14 - 15个月，p < 0.001）。TTFs之后时期的24个月总生存率为25.6%（95%置信区间24.5 - 26.8%），替莫唑胺之后/TTFs之前时期为24.7%（95%置信区间24.0 - 25.4%）。在一个考虑临床特征的多变量模型中，与替莫唑胺之后/TTFs之前时期相比，TTFs之后时期的诊断与总生存期显著相关（风险比：0.941，95%置信区间0.912 - 0.972，p < 0.001）。