Phuphanich S, Edwards M S, Levin V A, Vestnys P S, Wara W M, Davis R L, Wilson C B
J Neurosurg. 1984 Mar;60(3):495-9. doi: 10.3171/jns.1984.60.3.0495.
Twenty-seven patients aged 1 to 18 years harboring supratentorial (20 in the cerebrum and seven in the thalamus) malignant gliomas were treated between 1975 and 1982. There were four glioblastomas multiforme, 14 anaplastic astrocytomas, and nine malignant gliomas. All patients had a subtotal resection or biopsy as the initial procedure and received postoperative radiation therapy (RT). Fifteen of 27 patients were treated by RT alone; 14 had tumor progression with a median time to tumor progression (MTP) of 65 weeks. Twelve patients were treated with chemotherapy as an adjuvant to RT; only seven had tumor recurrence, with an MTP of 130 weeks. Of the 21 patients with recurrent tumors in both groups, 18 were treated with chemotherapy alone, or chemotherapy with a second surgical procedure or second course of RT. For all histological grades of tumor, the MTP for first recurrence was 75 weeks and the median survival time was 180 weeks. Age at initial diagnosis was found to be a statistically significant prognostic factor, with patients younger than 10 years of age surviving longer than patients aged over 10 years (p = 0.02).
1975年至1982年间，对27例年龄在1至18岁的幕上恶性胶质瘤患者进行了治疗（20例位于大脑，7例位于丘脑）。其中有4例多形性胶质母细胞瘤、14例间变性星形细胞瘤和9例恶性胶质瘤。所有患者均以次全切除或活检作为初始治疗手段，并接受了术后放射治疗（RT）。27例患者中有15例仅接受了放射治疗；14例出现肿瘤进展，肿瘤进展的中位时间（MTP）为65周。12例患者接受了化疗作为放射治疗的辅助治疗；只有7例出现肿瘤复发，MTP为130周。两组中21例复发肿瘤患者中，18例仅接受了化疗，或化疗联合第二次手术或第二轮放射治疗。对于所有组织学分级的肿瘤，首次复发的MTP为75周，中位生存时间为180周。发现初始诊断时的年龄是一个具有统计学意义的预后因素，10岁以下患者的生存期长于10岁以上患者（p = 0.02）。
