低级别胶质瘤:单一研究所的经验

Shahida Nasreen, A. Najmi, Asifa Andleeb, K. Fatima, M. Sofi, S. Banday
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摘要

低级别胶质瘤(LGG)是一种较为罕见的肿瘤。它们占所有脑瘤的5%和胶质瘤的15%。根据WHO的分类,弥漫性浸润性LGG属于II级肿瘤。虽然这些肿瘤生长缓慢,但最终会发展为高级胶质瘤,所以这些患者应该积极治疗。材料与方法:回顾性收集我院放射肿瘤科2012年1月至2017年1月收治的LGG患者的临床资料。结果:共分析25例患者。在整个队列中,64%为男性,36%为女性。我们的患者中最常见的症状是癫痫发作和视力模糊(各占44%)。25例中有19例(76.0%)以大脑为最常见的病变部位,其中12例(63.1%)累及额叶。所有患者均行开颅肿瘤减压术。在25例患者中,只有2例(8%)患者可以进行完全切除,而其余23例(92%)患者仅进行了次全或近全切除。这23名患者同时接受钴-60单位60gy剂量的放化疗,每周使用替莫唑胺。23例患者中有18例(78.2%)在同步放化疗后,考虑到残留疾病,接受了6个周期替莫唑胺的辅助治疗。最后一次随访时,25例患者全部存活,20例磁共振造影无病变,5例病情稳定。结论:我们认为LGG是一种以癫痫发作为最常见症状的年轻成人疾病。如果采用多学科治疗,这些患者有较长的无病无残生存期。我们研究组的神经认知功能障碍较低,但需要更长时间的随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Low-grade gliomas: A single-institute experience
Introduction: Low-grade gliomas (LGG) are relatively rare tumors. They comprise 5% of all brain tumors and 15% of all gliomas. As per WHO classification diffuse infiltrating LGG s fall under Grade II tumors. Although these tumors are slow growing but eventually they progress to high-grade gliomas, so these patients should be treated aggressively. Materials and Methods: From January 2012 to January 2017, clinical information of patients, who had LGG, was collected retrospectively from patient registries at the radiation oncology department of our institute. Results: A total of 25 patients were analyzed. Out of the entire cohort, 64% were males, and 36% were females. The most common presenting symptom in our patients was seizures and blurring of vision (44% each). Cerebrum was the mos common site of lesion in 19 out of 25 (76.0%) cases, and among those 19 cases, frontal lobe was involved in 12 cases (63.1%). Craniotomy with tumor decompression was performed in all patients. Gross total excision was possible in only 2 (8%) out of 25 patients, whereas the remaining 23 (92%) patients underwent subtotal or near total excision only. These 23 patients received concurrent chemoradiation by cobalt-60 unit to a dose of 60 Gy with weekly temozolomide. 18 out of 23 (78.2%) patients received adjuvant six cycles temozolomidein view of residual disease after concurrent chemoradiotherapy. At the last follow-up, all the 25 patients were alive, 20 patients had no disease on contrast-enhanced magnetic resonance imaging, while five patients had stable disease. Conclusion: We conclude that LGG is a disease of young adults with seizures as most common presenting symptom. If treated with multidisciplinary treatment these patients have the long disease and disability-free survival. Neurocognitive dysfunction is low in our study group, but it needs longer follow-up.
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