Prognostic and therapeutic factors of gliosarcoma from a multi-institutional series
Prognostic and therapeutic factors of gliosarcoma from a multi-institutional series
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DOI：
10.1007/s11060-016-2142-9
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发表时间：
2016-08-01
影响因子：
3.9
通讯作者：
Noel, G.
中科院分区：
文献类型：
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作者：
Castelli, J.;Feuvret, L.;Noel, G.
这项多中心回顾性研究的目的是确定影响胶质肉瘤患者总生存率的预后或治疗因素。该分析包括1998年至2014年期间在七个法国学术中心接受神经胶质肉瘤治疗的所有患者。75例中位年龄为60岁（范围为23 - 79岁）的患者接受了手术（n = 66）、放疗（64例患者为辅助放疗，8例患者为单独放疗）和基于替莫唑胺的化疗（n = 58）的联合治疗。中位随访时间为12个月（范围为2至71个月）。2年总生存率（OS）和无病生存率分别为12%（95%CI 4- 20%）和2%（95%CI 0- 6%）。中位OS为13个月。复发时的治疗包括化疗（n = 38）（18例患者为贝伐单抗，10例患者为重复替莫唑胺），挽救手术（n = 8）和放化疗（n = 1）。在单因素分析中，年龄越小、放疗总剂量越高、复发时间越长和复发时治疗越能显著增加OS。（HR = 0.97，p = 0.007）和复发时的治疗最小剂量54戈伊放疗和挽救治疗可提高胶质肉瘤的OS。与胶质母细胞瘤不同，在我们的分析中，与仅接受放射治疗的患者相比，TMZ化疗与OS改善无关。
The aims of this multicentre retrospective study were to identify prognostic or therapeutic factors impacting on overall survival in patients with gliosarcoma. The analysis included all patients treated for gliosarcoma between 1998 and 2014 in seven French academic centres. Seventy-five patients with a median age of 60 years (range from 23 to 79 years) were treated with a combination of surgery (n = 66), radiotherapy (adjuvant for 64 patients and exclusive for 8 patients) and temozolomide based chemotherapy (n = 58). Median follow-up was 12 months (range from 2 to 71 months). Two-year overall survival (OS) and disease free survival rates were 12 % (95 % CI 4-20 %) and 2 % (95 % CI 0-6 %), respectively. The median OS was 13 months. Treatment at recurrence consisted of chemotherapy (n = 38) (bevazicumab for 18 patients, repeat temozolomide for 10 patients), salvage surgery (n = 8) and radiochemotherapy (n = 1). In univariate analysis, younger age, higher total dose of radiotherapy, longer time to recurrence and treatment at recurrence significantly increased OS. In multivariate analysis, high total dose of radiotherapy (HR = 0.97, p = 0.007) and treatment at recurrence (HR = 0.28, p < 0.001) were favourable prognostic factors of OS. Radiotherapy at a minimum dose of 54 Gy and salvage treatment increased OS of gliosarcoma. Unlike glioblastoma, in our analysis, TMZ based chemotherapy was not associated with an improvement in OS compared to patients who received radiation therapy only.