Overall survival after carmustine wafers implantation for newly-diagnosed high grade glioma. A nationwide population-based controlled propensity score-matched analysis

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-08-12 DOI:10.1016/j.clineuro.2025.109081

Charles Champeaux Depond , Vincent Jecko , Joconde Weller , Philippe Tuppin , Philippe Metellus

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引用次数: 0

Abstract

Objective

Widespread use of carmustine wafers (CW) for high-grade gliomas (HGG) has been limited by uncertainties about its efficacy. This study aimed to evaluate the overall survival (OS) of patients who underwent CW implantation after newly-diagnosed HGG resection.

Methods

In this retrospective study, we processed the French medico-administrative national database to retrieve ad hoc cases. Propensity score-matched (PSM) analysis was performed to reduce bias from confounding patient-related variables and, OS was compared between the two groups.

Results

A total of 2956 newly-diagnosed HGG patients who were post-operatively treated according the chemoradiotherapeutic Stupp regimen between the 1st January 2008 and the 31st December 2019 were extracted from the SNDS. 1518 (51.4 %) of these patients had CW implantation at HGG surgery. From the total recruited, 1604 (54.3 %) had missing data for at least 1 of the variables used to calculate the PS and, thus had to be excluded. Of the 1352 remaining subjects, we paired 500 treated patients with 852 controls. The median survival time for the treated group was 1.53 versus 1.42 years for the control group (p = 0.299). The estimated difference in restricted mean survival time between groups at 1, 2, 3 and 5 years were 0.02, _95 %CI[-0.02–0.05], p = 0.326; 0.06, _95 %CI[-0.04–0.16], p = 0.213; 0.11, _95 %CI[-0.04–0.27], p = 0.153 and 0.13, _95 %CI[-0.12–0.37], p = 0.322 respectively.

Conclusion

CW implantation with standard chemoradiotherapeutic treatment after newly-diagnosed HGG surgery did not increase the OS of patients.

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新诊断的高级别胶质瘤植入卡莫司汀晶片后的总生存率。以全国人口为基础的控制倾向评分匹配分析

目的卡莫司汀片（CW）在高级别胶质瘤（HGG）中的广泛应用受到其疗效不确定性的限制。本研究旨在评估新诊断的HGG切除术后接受CW植入的患者的总生存率（OS）。方法在这项回顾性研究中，我们处理了法国医学管理国家数据库，以检索特殊病例。进行倾向评分匹配（PSM）分析以减少混杂患者相关变量的偏倚，并比较两组间的OS。结果从SNDS中提取2008年1月1日至2019年12月31日采用Stupp方案术后治疗的新诊断HGG患者2956例。1518例（51.4 %）患者在HGG手术中植入连续波。从招募的总人数中，1604人（54.3% %）至少有1个用于计算PS的变量数据缺失，因此必须排除。在剩余的1352名受试者中，我们将500名治疗患者与852名对照组配对。治疗组的中位生存时间为1.53年，对照组为1.42年（p = 0.299）。1、2、3、5年组间受限平均生存时间的估计差异分别为0.02、95 %CI[-0.02-0.05], p = 0.326；0.06, 95 %CI[-0.04-0.16], p = 0.213；0.11, 95 % CI [-0.04 - -0.27], p = 0.153和0.13,95 % CI [-0.12 - -0.37], p = 分别为0.322。结论新诊断的HGG手术后给予标准放化疗的cw植入术并没有增加患者的OS。

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

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.