Medicine:恶性胶质瘤治疗新进展!

2017-07-08 shaosai MedSci原创

胶质细胞瘤或许是一种临床上越治越烈的刺头,直叫神经外科外科医生头痛。哪怕是鬼斧神工、庖丁解牛使出浑身解数也是以黔驴技穷告终。最近,有研究对恶性胶质瘤术后并行同期放化疗进行了研究,旨在探究术后一系列治疗的疗效,同时评估一下能够预测疗效的影响因素,并将研究结果发表在Medicine上。

胶质细胞瘤或许是一种临床上越治越烈的刺头,直叫神经外科外科医生头痛。哪怕是鬼斧神工、庖丁解牛使出浑身解数也是以黔驴技穷告终。最近,有研究对恶性胶质瘤术后并行同期放化疗进行了研究,旨在探究术后一系列治疗的疗效,同时评估一下能够预测疗效的影响因素,并将研究结果发表在Medicine上。

本研究自2005年至2013年在作者单位单独进行,主要纳入了252名新诊胶质母细胞瘤(CMM)并行手术以及服用替莫唑胺(TMZ)的同期放化疗(CCRT)的患者。研究人员对术后CCRT的疗效进行了分析研究。

在初次手术中,分别有126例(50.0%),55例(21.8%),45例(17.9% ),26例(10.3%)患者进行了广泛切除术(GTR),大部切除术,部分切除术(PR)和病理活检。他们的中位总生存期(OS)为20.8个月(95%置信区间[CI] 17.7-23.9个月),其中位无进展生存期为12.7个月(95%CI为11.2-14.2个月)。

在化验的229例患者中,有78例(34.1%)患者O-甲基鸟嘌呤-DNA甲基转移酶(MGMT)启动子发生甲基化,在106例患者中有7例(6.6%)检测到异柠檬酸脱氢酶1发生突变。单变量分析显示,患者年龄、受累脑功能区、脑室旁区、软脑膜的转移、卡氏评分、切除程度(EOR)、MGMT启动子甲基化以及胶质瘤组分的存在都是OS的预后因子。多变量分析显示年龄、受累脑功能区、软脑膜的转移、EOR、MGMT启动子甲基化对OS都有准确地预测作用。

在术后服用TMZ接受CCRT 的GBM患者在肿瘤完全切除后OS明显增加。患者的年龄、受累脑功能区、软脑膜的转移、MGMT启动子甲基化对OS都有准确地预测作用。

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    2017-09-26 kalseyzl
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    2018-01-12 柳叶一刀
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