Long-Term Follow-Up of Children Treated for High-Grade Gliomas: Children's Oncology Group L991 Final Study Report
Long-Term Follow-Up of Children Treated for High-Grade Gliomas: Children's Oncology Group L991 Final Study Report
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DOI：
10.1200/jco.2011.35.7533
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发表时间：
2012-03-20
影响因子：
45.3
通讯作者：
Finlay, Jonathan Lester
中科院分区：
文献类型：
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作者：
Sands, Stephen Alan;Zhou, Tianni;Finlay, Jonathan Lester
目的中枢神经系统高级别胶质瘤的特点是治疗反应差和长期生存预后差。儿童肿瘤组 (COG) L991 研究调查了儿童癌症组 (CCG) 高级神经胶质瘤试验 (CCG-945) 治疗后的神经心理、行为和生活质量 (QoL) 结果。患者和方法 54 名患者（29 名男性，25 名女性）诊断时中位年龄为 8.8 岁（范围为 0.2 至 19.5 岁）在北美 25 个机构注册，占可用幸存者的 81%；中位随访时间为 15.1 年（范围为 9.5 至 19.2 岁），研究评估时的中位年龄为 23.6 岁（范围为 11.3 至 36 岁）。进行了神经心理功能和生活质量的标准化测试。描述性统计总结了主要发现，单向方差分析确定了结果的潜在预测因素。结果平均随访时间为 15 年，幸存者表现出的智力功能处于低平均范围内。执行功能和言语记忆处于低平均水平和边缘范围之间。相比之下，视觉记忆和精神运动处理速度分别位于临界范围和受损范围之间。大约 75% 的患者报告身体和心理领域的总体生活质量处于或高于正常范围。非半球肿瘤位置（中线或小脑）、女性和治疗时的年轻年龄成为独立的危险因素。 结论 除了确定需要进一步研究和主动干预以尽量减少后期影响同时努力确保生存的高危人群之外，这些结果还可以作为与未来儿科高级别神经胶质瘤研究进行比较的基准。 J 临床肿瘤杂志 30：943-949。 (C) 2012 年美国临床肿瘤学会
PurposeHigh-grade gliomas of the CNS are characterized by poor treatment response and prognosis for long-term survival. The Children's Oncology Group (COG) L991 study investigated the neuropsychological, behavioral, and quality of life (QoL) outcomes after treatment on the Children's Cancer Group (CCG) trial for high-grade gliomas (CCG-945).Patients and MethodsFifty-four patients (29 males, 25 females) with a median age of 8.8 years at diagnosis (range, 0.2 to 19.5 years) were enrolled at 25 institutions in North America, representing 81% of available survivors; median length of follow-up was 15.1 years (range, 9.5 to 19.2 years), and median age at study evaluation was 23.6 years (range, 11.3 to 36 years). Standardized tests of neuropsychological functioning and QoL were performed. Descriptive statistics summarized principal findings, and one-way analysis of variance identified potential predictors of outcomes.ResultsWith an average follow-up time of 15 years, survivors demonstrated intellectual functioning within the low-average range. Executive functioning and verbal memory were between the low-average and borderline ranges. In contrast, visual memory and psychomotor processing speed were between the borderline and impaired ranges, respectively. Approximately 75% of patient reported overall QoL within or above normal limits for both physical and psychosocial domains. Nonhemispheric tumor location (midline or cerebellum), female sex, and younger age at treatment emerged as independent risk factors.ConclusionThese results serve as a benchmark for comparison with future pediatric high-grade glioma studies, in addition to identifying at-risk cohorts that warrant further research and proactive interventions to minimize late effects while striving to ensure survival. J Clin Oncol 30: 943-949. (C) 2012 by American Society of Clinical Oncology