INFLUENCE OF EXTENT OF SURGERY AND TUMOR LOCATION ON TREATMENT OUTCOME OF PATIENTS WITH GLIOBLASTOMA-MULTIFORME TREATED WITH COMBINED-MODALITY APPROACH
INFLUENCE OF EXTENT OF SURGERY AND TUMOR LOCATION ON TREATMENT OUTCOME OF PATIENTS WITH GLIOBLASTOMA-MULTIFORME TREATED WITH COMBINED-MODALITY APPROACH
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DOI：
10.1007/bf01052902
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发表时间：
1994-01-01
影响因子：
3.9
通讯作者：
SHIBAMOTO, Y
中科院分区：
文献类型：
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作者：
JEREMIC, B;GRUJICIC, D;SHIBAMOTO, Y
1988年至1991年间，我们对86例多形性胶质母细胞瘤患者进行了评估，以确定手术范围和肿瘤位置对治疗结果的影响。患者接受手术，术后进行高分割放疗和化疗，根据两种连续方案中的一种进行。手术包括25例（29%）患者活检和61例（71%）患者肿瘤次全或总切除。26例（30%）患者的肿瘤位于额部，60例（70%）患者的肿瘤位于其他部位。接受更多根治性手术的患者比仅行活检的患者有更长的中位生存时间（MST）和更高的1年和2年生存率（分别为56周和29周；分别为62%和23%对16%和0%；p = 0.00000）。与其他肿瘤位置的患者相比，额部肿瘤患者的MST更长，1年和2年生存率更高（分别为101周和47周；分别为76%和44%；分别为37%和2.5%;p = 0.00001）。多因素分析证实手术范围和肿瘤部位是影响多形性胶质母细胞瘤患者预后的独立因素。关于无进展生存期，接受根治性手术的患者比只接受活检的患者有更长的中位肿瘤进展时间（MTP）（分别为33周和21周）。此外，根治性切除组1年无进展生存率高于单纯活检组（分别为20% vs 0%； p = 0.00000）。与其他肿瘤位置的患者（分别为28周和1.7%,p = 0.00002）相比，额部肿瘤患者的MTP（42周）更长，1年无进展生存率（42%）更高。多因素分析证实，以无进展生存期为终点，采用联合治疗方法治疗多形性胶质母细胞瘤患者，手术范围和肿瘤位置是独立的预后因素。
Between 1988 and 1991, eighty-six patients with glioblastoma multiforme were evaluated in order to define the influence of extent of surgery and tumor location on treatment outcome. Patients underwent surgery followed by postoperative hyperfractionated radiotherapy and chemotherapy delivered according to one of two consecutive protocols. Surgery consisted of biopsy in 25 (29%) patients and subtotal or gross total tumor resection in 61 (71%) patients. Frontally located tumors were noted in 26 (30%) patients and other tumor locations were noted in 60 (70%) patients. Patients having more radical surgery had longer median survival time (MST) and higher 1- and 2-year survival rates than those with biopsy only (56 vs 29 weeks, respectively; 62% and 23% vs 16% and 0%, respectively; p = 0.00000). Patients having frontally located tumors had longer MST and higher 1- and 2-year survival rates than those with other tumor locations (101 vs 47 weeks, respectively; 76% and 44% vs 37% and 2.5%, respectively; p = 0.00001). Multivariate analysis confirmed that extent of surgery and tumor location were independent prognostic factors in patients with glioblastoma multiforme. Regarding progression-free survival, patients having more radical surgery had longer median time to tumor progression (MTP) than those with biopsy only (33 weeks vs 21 weeks, respectively). Also, progression-free survival at 1 year was higher in radically resected group than in biopsy only group (20% vs 0%, respectively; p = 0.00000). Patients with frontally located tumors had longer MTP (42 weeks) and higher progression-free survival at 1 year (42%) than those with other tumor location (28 weeks and 1.7%, respectively; p = 0.00002). Multivariate analysis confirmed that the extent of surgery and tumor location are independent prognosticators in patients with glioblastoma multiforme treated with combined modality approach using progression-free survival as an endpoint.