生存期分析及与分子流行病学的相关性:巴基斯坦高级别胶质瘤 10 年回顾性系列研究。

Journal of cancer & allied specialties Pub Date : 2024-01-22 eCollection Date: 2024-01-01 DOI:10.37029/jcas.v10i1.565
Mashal Shah, Saad Bin Anis, Irfan Yusuf, Mohammad Hamza Bajwa
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引用次数: 0

摘要

简介高级别胶质瘤是一种恶性、复发性原发性中枢神经系统(CNS)肿瘤,需要大量的术后化疗和放疗。异柠檬酸脱氢酶(IDH)、1p19q 和 ATRX 基因突变对患者的生存和化疗反应有显著影响,这一点在全球北方地区的许多广泛研究中都有体现。本研究旨在根据分子特征报告当地地区的无进展生存期和总生存期数据:巴基斯坦拉合尔的肖卡特-卡努姆纪念癌症医院和研究中心开展了一项为期 10 年的回顾性系列研究,共有 285 名患者在 2008 年至 2018 年期间就诊。收集了前瞻性随访数据,并为2010年以后的患者提供了完整的分子图谱。通过卡普兰-梅耶法进行生存分析,并报告对数秩:70.53%的患者(201人)为男性,诊断时的平均年龄为(43.33 ± 15.1)岁。队列中有 265 名患者完成了术后放疗,141 名患者接受了化疗(丙卡巴嗪、洛莫司汀和长春新碱或替莫唑胺)。队列中以月为单位的平均生存期如下:胶质母细胞瘤(14.1 个月)、无细胞星形细胞瘤(27.5 个月)和无细胞少突胶质细胞瘤(39.8 个月)。生存曲线显示,来自巴基斯坦的IDH野生型肿瘤(P < 0.0001)、ATRX突变肿瘤(P = 0.029)和1p19q未缺失肿瘤(P = 0.008)的生存率较低:我们的研究结果量化了巴基斯坦高级别胶质瘤患者的长期生存结果,分析了各种治疗模式。尤其重要的是,分子亚分类可显著预测IDH、ATRX和1p19共缺失突变的生存结果。扩大脑肿瘤流行病学将有利于评估地区肿瘤中心的疗效和建立治疗标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Survival Analysis and Correlates with Molecular Epidemiology: 10-Year Retrospective Series of High-Grade Glioma in Pakistan.

Introduction: High-grade gliomas are malignant, recurring primary central nervous system (CNS) tumors requiring extensive postoperative chemotherapy and radiation treatment. Isocitrate dehydrogenase (IDH), 1p19q, and ATRX mutations significantly influence survival and response to chemotherapy, as seen in many extensive studies from the Global North. This study aims to report data from the local region regarding progression-free survival and overall survival in light of molecular characteristics.

Materials and methods: A 10-year retrospective series was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, with 285 patients presenting from 2008 to 2018. Prospective follow-up data was collected, and complete molecular profiles were available for patients presenting from 2010 onwards. Survival analysis was conducted through the Kaplan-Meier method, with log-rank reported.

Results: 70.53% (201) of patients were male, with a mean age at diagnosis of 43.33 ± 15.1 years. 265 patients within the cohort completed postoperative radiotherapy, while 141 patients underwent chemotherapy (procarbazine, lomustine, and vincristine, or temozolomide). Mean survival, in months, within the cohort was as follows: glioblastoma (14.1), anaplastic astrocytoma (27.5), and anaplastic oligodendroglioma (39.8). Survival curves showed a lower survival for IDH wild-type (P < 0.0001), ATRX mutated (P = 0.029), and 1p19q non-deleted (P = 0.008) tumors from Pakistan.

Discussion: Our findings quantified long-term survival outcomes for high-grade glioma from Pakistan, analyzing the various treatment patterns. Of particular importance, molecular sub-classification significantly predicted survival outcomes for IDH, ATRX, and 1p19 co-deletion mutations. Expanding brain tumor epidemiology will benefit assessing the efficacy of regional oncological centers and establishing standards of care.

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