Age influences chemotherapy response in astrocytomas
Age influences chemotherapy response in astrocytomas
复制标题
年龄影响星形细胞瘤的化疗反应
作者：
R. Grant;B. Liang;M. Page;D. Crane;H. Greenberg;L. Junck
目的在接受亚硝脲为主的化疗的脑星形细胞瘤患者中，确定年龄是否预测疗效、进展时间、生存时间或并发症发生率。设计对神经影像研究和临床资料进行回顾性分析。为大学医院提供繁忙的神经肿瘤学服务。148例经病理证实的恶性星形细胞瘤或复发性星形细胞瘤患者。结果40岁以上患者中有39%出现部分缓解，40~59岁患者中有17%出现部分缓解，而60岁≤患者中仅有5%出现部分缓解(p<；0.001)。60岁的患者化疗后进展的中位时间为23周，60岁的≤患者为6周(p<；0.001)。60岁的患者化疗后的中位生存期为43周，而60岁的≤患者仅为24周(p<；0.001)。随着肿瘤分级的调整，不同年龄组在反应率、进展时间和生存期方面的差异持续存在。需要住院的骨髓抑制并发症的风险与年龄显著相关(p=0.03)；这种并发症发生在≤60岁的患者中有35%，60岁以下的患者中有16%。结论年龄对化疗有效的可能性、进展时间、生存期和骨髓抑制并发症的风险有很强的预测作用。与年轻患者相比，≤60岁的患者从星形细胞瘤化疗中受益的机会较低，而骨髓抑制并发症的风险较高。
Objective In patients with cerebral astrocytomas treated with nitrosourea-based chemotherapy, to determine whether age is predictive of response, time to progression, survival, or rate of complications. Design Retrospective analysis of neuroimaging studies and clinical data. Setting University hospital with a busy neuro-oncology service. Patients One hundred forty-eight patients with pathologically confirmed malignant astrocytomas or recurrent astrocytomas. Results Partial response occurred in 39% of patients aged <40 years, in 17% of those aged 40 to 59, and in only 5% of those aged ≤60 (p < 0.001). Median time to progression after chemotherapy was 23 weeks in patients aged <60 and 6 weeks in patients aged ≤60 (p < 0.001). Median survival after chemotherapy was 43 weeks in patients aged <60 but only 24 weeks in patients aged ≤60 (p < 0.001). Differences between age groups in response rate, time to progression, and survival persisted with adjustment for tumor grade. The risk of myelosuppressive complications requiring hospitalization was significantly related to age (p = 0.03); such complications occurred in 35% of patients aged ≤60 and 16% of patients under 60 years. Conclusion Age is strongly predictive of the likelihood of a response to chemotherapy, time to progression, survival, and risk of myelosuppressive complications. Patients aged ≤60 have a lower chance of benefit and an increased risk of myelosuppressive complications from chemotherapy for astrocytomas compared with younger patients.
BCNU 与羟基脲放疗后联合使用丙卡巴肼、CCNU 和长春新碱治疗恶性胶质瘤的 III 期比较。
影响因子：
4.1
作者：
Levin,VA;Wara,WM;Davis,RL;Vestnys,P;Resser,KJ;Yatsko,K;Nutik,S;Gutin,PH;Wilson,CB
通讯作者：
Wilson,CB