单纯活检不可切除的IDH野生型胶质母细胞瘤放化疗的可行性

IF 2.4 Q2 CLINICAL NEUROLOGY
Vincent Harlay, Romain Appay, Céline Bequet, Gregorio Petrirena, Chantal Campello, Maryline Barrié, Didier Autran, Thomas Graillon, Sébastien Boissonneau, Henry Dufour, Dominique Figarella-Branger, Laetitia Padovani, Anne Barlier, Isabelle Nanni, Emeline Tabouret, Olivier Chinot
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The median age was 66 years old and the median KPS was 70. Forty-six patients (33.6%) were referred to radiotherapy and chemotherapy (RT–TMZ) regimen, 75 (54.7%), considered unfitted for RT, received chemotherapy upfront (CT) and 16 (11.7%) were referred to palliative care (PC). Regarding the first group, 91% of patients completed the RT–TMZ. In the CT group, 11 of 75 patients (14.7%) underwent radiotherapy after chemotherapy upfront. Median overall survival was 12.3 months (95% CI, 15.30–24.16), 5.7 months (95% CI, 6.22–9.20), and 1.9 months (95% CI, 1.43–5.08) in RT–TMZ, CT, and PC groups, respectively. In multivariate analyses, progression-free survival was impacted by baseline KPS (P &amp;lt; .001) and MGMT status (P = .004). Overall survival was impacted by baseline KPS (P &amp;lt; .001) and age (P = .030). 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引用次数: 1

摘要

背景“仅活组织检查”胶质母细胞瘤(BO-GBM)是一种异质性的、研究不足的患者群体,其预后较差。我们的目的是探讨本中心与BO-GBM相关的护理模式和预后。方法回顾性分析2014年开始并于2017年结束的前瞻性区域队列中IDH野生型BO-GBM患者的患者特征、MRI表现、治疗分配和递送。结果在纳入队列的535例患者中,137例患者被纳入本分析。平均年龄为66岁,平均KPS为70岁。46例(33.6%)患者转入放化疗(RT - tmz)方案,75例(54.7%)患者认为不适合RT,接受化疗(CT), 16例(11.7%)患者转入姑息治疗(PC)。第一组91%的患者完成了RT-TMZ。在CT组,75例患者中有11例(14.7%)在化疗后进行了前期放疗。RT-TMZ、CT和PC组的中位总生存期分别为12.3个月(95% CI, 15.30-24.16)、5.7个月(95% CI, 6.22-9.20)和1.9个月(95% CI, 1.43-5.08)。在多变量分析中,无进展生存期受到基线KPS (P <.001)和MGMT状态(P = .004)。总生存期受基线KPS (P <.001)和年龄(P = .030)。结论BO-GBM是一个庞大且异质性的人群,其中三分之一的患者可以接受标准治疗,其生存结局接近于接受手术的患者之一。需要可靠的标准来帮助选择适当治疗的患者,而对于不适合RT的BO-GBM则需要新的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radio-chemotherapy feasibility for biopsy-only unresectable IDH wild-type glioblastomas (BO-GBM)
Abstract Abstract Background “Biopsy-only” glioblastoma (BO-GBM) is a heterogeneous, understudied group of patients associated with a poor outcome. Our objective was to explore the pattern of care and prognosis associated with BO-GBM in our center. Methods Patients with IDH wild-type BO-GBM included in a prospective regional cohort initiated in 2014 and closed in 2017 were retrospectively reviewed for patient characteristics, MRI findings, treatment allocation, and delivery. Results Of 535 patients included in the cohort, 137 patients were included in the present analysis. The median age was 66 years old and the median KPS was 70. Forty-six patients (33.6%) were referred to radiotherapy and chemotherapy (RT–TMZ) regimen, 75 (54.7%), considered unfitted for RT, received chemotherapy upfront (CT) and 16 (11.7%) were referred to palliative care (PC). Regarding the first group, 91% of patients completed the RT–TMZ. In the CT group, 11 of 75 patients (14.7%) underwent radiotherapy after chemotherapy upfront. Median overall survival was 12.3 months (95% CI, 15.30–24.16), 5.7 months (95% CI, 6.22–9.20), and 1.9 months (95% CI, 1.43–5.08) in RT–TMZ, CT, and PC groups, respectively. In multivariate analyses, progression-free survival was impacted by baseline KPS (P &lt; .001) and MGMT status (P = .004). Overall survival was impacted by baseline KPS (P &lt; .001) and age (P = .030). Conclusion BO-GBM constitute a large and heterogeneous population in which one-third of patients is amenable to the standard of care, with survival outcome close to one of the patients who underwent surgery. Reliable criteria are needed to help select patients for adequate treatment while new strategies are warranted for BO-GBM unfit for RT.
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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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