Radiation combined with temozolomide contraindicated for young adults diagnosed with anaplastic glioma.
Radiation combined with temozolomide contraindicated for young adults diagnosed with anaplastic glioma.
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DOI：
10.18632/oncotarget.11756
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发表时间：
2016-11-29
期刊：
影响因子：
--
通讯作者：
Jiang T
中科院分区：
文献类型：
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作者：
Yang P;Zhang C;Cai J;You G;Wang Y;Qiu X;Li S;Wu C;Yao K;Li W;Peng X;Zhang W;Jiang T
年龄是恶性胶质瘤的主要预后因素。然而，很少有研究调查了年轻人胶质瘤的管理。我们从中国神经胶质瘤基因组图谱（CGGA）中确定了大量年轻成人晚期神经胶质瘤患者的生存和治疗作用。本研究纳入了726例经组织学证实的间变性胶质瘤或多形性胶质母细胞瘤（GBM）成人（年龄≥ 18岁）。在年轻组（年龄< 50岁）和老年组（年龄≥ 50岁）中确定总体和无进展生存期。该研究包括264例老年组（OP）和462例年轻组（YP）。在伴有GBM和间变性胶质瘤的OP组中，RT联合替莫唑胺（TMZ）治疗组的OS和PFS显著长于单纯RT组（P < 0.05）。与此相反，诊断为间变性胶质瘤的YP组与单纯RT相比，RT加TMZ未能显示出任何生存优势。我们观察到TMZ联合RT治疗年轻（< 50岁）间变性胶质瘤患者没有生存获益。我们的研究结果值得进一步研究诊断为间变性胶质瘤的年轻患者接受放疗联合TMZ化疗。
Age is a major prognostic factor for malignant gliomas. However, few studies have investigated the management of gliomas in young adults. We determined the role of survival and treatment in young adults with advanced gliomas in a large population from the Chinese Glioma Genome Atlas (CGGA). This study included 726 adults (age ≥ 18) with histologically proven anaplastic glioma or glioblastoma multiforme (GBM). The overall and progression-free survival was determined in young (age < 50) and older groups (age ≥ 50). The study included an older group (OP) of 264 patients and a younger group (YP) of 462patients. In the OP group with GBM and anaplastic glioma, patients treated with RT combined with temozolomide (TMZ) manifested significantly longer OS and PFS compared with patients assigned to RT alone (P < 0.05). In contrast, the YP group diagnosed with anaplastic glioma failed to show any survival advantage with RT plus TMZ compared with RT alone. We observed no survival benefit in young adults (age < 50) with anaplastic glioma when treated with TMZ combined with RT. Our findings warrant further investigation of younger patients diagnosed with anaplastic glioma treated with radiotherapy plus TMZ chemotherapy.