Stereotactic Radiosurgery for World Health Organization Grade 2 and 3 Oligodendroglioma: An International Multicenter Study.

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Neurosurgery Pub Date : 2025-04-01 Epub Date: 2024-09-20 DOI:10.1227/neu.0000000000003177

Anne-Marie Langlois, Christian Iorio-Morin, Justiss Kallos, Ajay Niranjan, L Dade Lunsford, Selcuk Peker, Yavuz Samanci, David J Park, Gene H Barnett, Roman Liscak, Gabriela Simonova, Stylianos Pikis, Georgios Mantziaris, Jason Sheehan, Cheng-Chia Lee, Huai-Che Yang, Greg N Bowden, David Mathieu

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引用次数: 0

Abstract

Background and objectives: Oligodendrogliomas are primary brain tumors classified as isocitrate deshydrogenase-mutant and 1p19q codeleted in the 2021 World Health Organization Classification of central nervous system tumors. Surgical resection, radiotherapy, and chemotherapy are well-established management options for these tumors. Few studies have evaluated the efficacy of stereotactic radiosurgery (SRS) for oligodendroglioma. As these tumors are less infiltrative than astrocytomas and typically recur locally, focal therapy such as SRS is an appealing option.

Methods: This study was performed through the International Radiosurgery Research Foundation. The objective was to collect retrospective multicenter data on tumor control, clinical response, and morbidity after SRS for oligodendroglioma. Inclusion criteria were age of 18 years or more, single-fraction SRS, and histological confirmation of grade 2 or 3 oligodendroglioma. The primary end points were progression-free survival (PFS) and overall survival from SRS. Secondary end points included clinical evolution and occurrence of adverse radiation events or other complications. Descriptive statistics, Kaplan-Meier analyses, and univariate and multivariate analyses were performed.

Results: Eight institutions submitted data for a total of 55 patients. The median follow-up time was 24 months. The median age at SRS was 46 years, and the median Karnofsky Performance Status was 90%. The median marginal dose used was 15 Gy. The median PFS was 17 months, with actuarial rates of 60% at 1 year, 31% at 2 years, and 24% at 5 years after SRS. Factors significantly associated with worsened PFS were World Health Organization grade 3, previous radiotherapy and chemotherapy, and higher marginal dose. The median overall survival post-SRS was 58 months, with actuarial rates of 92% at 1 year, 83% at 2 years, and 49% at 5 years. Karnofsky Performance Status remained stable post-SRS in 51% and worsened in 47% of patients, most often because of tumor progression (73%). Radiation-induced changes occurred in 30% of patients, of which only 4 were symptomatic.

Conclusion: SRS is a reasonable management option for patients with oligodendroglioma.

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立体定向放射外科治疗世界卫生组织2级和3级少突胶质细胞瘤：一项国际多中心研究。

背景与目的：少突胶质细胞瘤是一种在2021年世界卫生组织中枢神经系统肿瘤分类中被分类为异柠檬酸脱氢酶突变型和1p19q编码型的原发性脑肿瘤。手术切除、放疗和化疗是这些肿瘤公认的治疗选择。很少有研究评估立体定向放射手术（SRS）治疗少突胶质细胞瘤的疗效。由于这些肿瘤的浸润性不如星形细胞瘤，而且通常会局部复发，因此局灶性治疗（如SRS）是一种很有吸引力的选择。方法：本研究通过国际放射外科研究基金会进行。目的是收集关于少突胶质细胞瘤SRS后肿瘤控制、临床反应和发病率的回顾性多中心数据。纳入标准为年龄18岁或以上，单分数SRS，组织学证实为2级或3级少突胶质细胞瘤。主要终点是无进展生存期（PFS）和SRS的总生存期。次要终点包括临床进展和不良放射事件或其他并发症的发生。进行描述性统计、Kaplan-Meier分析、单因素和多因素分析。结果：8家机构共提交了55例患者的数据。中位随访时间为24个月。SRS时的中位年龄为46岁，中位Karnofsky Performance Status为90%。使用的中位边际剂量为15戈瑞。中位PFS为17个月，SRS后1年精算率为60%，2年为31%，5年为24%。与PFS恶化显著相关的因素是世界卫生组织分级3级、既往放疗和化疗以及较高的边际剂量。srs后的中位总生存期为58个月，精算率为1年92%，2年83%，5年49%。51%的患者srs后Karnofsky表现状态保持稳定，47%的患者恶化，最常见的原因是肿瘤进展（73%）。30%的患者发生放射性改变，其中只有4例有症状。结论：SRS是治疗少突胶质细胞瘤的合理选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurosurgery 医学-临床神经学

CiteScore

8.20

自引率

6.20%

发文量

898

审稿时长

2-4 weeks

期刊介绍： Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.