Schild S E, Stafford S L, Brown P D, Wood C P, Scheithauer B W, Schomberg P J, Wong W W, Lyons M K, Shaw E G
Mayo Clinic Scottsdale, Department of Radiation Oncology, AZ 85259, USA.
J Neurooncol. 1998 Nov;40(2):171-7. doi: 10.1023/a:1006193306286.
This analysis was performed to examine the outcome of adult and pediatric patients with brainstem tumors.
Forty patients with brainstem glioma were evaluated retrospectively. Included were 24 females and 16 males ranging in age from 3 to 81 years (median, 29.5 years). These patients were treated with various combinations of surgery, chemotherapy, and radiotherapy (RT). The length of follow-up in survivors ranged from 0.6 to 20 years (median: 3.2 years, mean: 6 years). Survival rates were calculated with the Kaplan Meier method and differences between survival curves were calculated using the log-rank test.
The overall 2 and 5-year survival rates were 44% and 34%, respectively. The median survival time was 19 months. The 5-year survival rate was 54% for patients with tumors outside the pons compared to 21% for those with tumors involving the pons (p = 0.04). The 5-year survival rate was 59% for patients with exophytic tumors as compared to 23% for those with intrinsic tumors (p = 0.05). Patients undergoing subtotal resection had a 5-year survival rate of 53% compared to 28% for those having only a biopsy or no surgical intervention (p = 0.04). None of the other potential prognostic or treatment related factors evaluated [patient age, tumor grade, tumor histology, radiotherapy parameters (including BID fractionation, 3-D treatment planning, or the use of doses > 55 Gy), or the administration of adjuvant chemotherapy] evaluated were associated with patient survival.
Brainstem gliomas generally occur in younger individuals. The survival rates were better for patients with exophytic tumors, those involving sites other than the pons, and tumors amenable to subtotal resection. Improvements in the outcome of patients with brainstem gliomas will require new therapeutic approaches.
进行此项分析以研究成人和儿童脑干肿瘤患者的预后情况。
对40例脑干胶质瘤患者进行回顾性评估。其中包括24例女性和16例男性，年龄范围为3至81岁（中位数为29.5岁）。这些患者接受了手术、化疗和放疗（RT）的各种联合治疗。幸存者的随访时间为0.6至20年（中位数：3.2年，平均：6年）。采用Kaplan-Meier方法计算生存率，并使用对数秩检验计算生存曲线之间的差异。
总体2年和5年生存率分别为44%和34%。中位生存时间为19个月。脑桥外肿瘤患者的5年生存率为54%，而累及脑桥的肿瘤患者为21%（p = 0.04）。外生性肿瘤患者的5年生存率为59%，而内生性肿瘤患者为23%（p = 0.05）。接受次全切除的患者5年生存率为53%，而仅进行活检或未进行手术干预的患者为28%（p = 0.04）。所评估的其他潜在预后或治疗相关因素[患者年龄、肿瘤分级、肿瘤组织学、放疗参数（包括每日两次分割、三维治疗计划或使用剂量>55 Gy）或辅助化疗的使用]均与患者生存无关。
脑干胶质瘤通常发生于较年轻个体。外生性肿瘤患者、累及脑桥以外部位的肿瘤患者以及适合次全切除的肿瘤患者生存率更高。改善脑干胶质瘤患者的预后需要新的治疗方法。
