2级质瘤的演变实践和结果:来自多机构注册表的现实数据
Lucy Gately1,2, Katharine Drummond3,4, Anthony Dowling5,6
1Personalised Oncology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia.
Cancers
|October 26, 2024
概括
放射治疗后的化疗 (CRT) 改善了高风险的2级质瘤患者的无进展生存率. 现实世界的数据显示,随着时间的推移,CRT的使用增加了,但观察仍然很常见,突出了对生物标志物的需求,以指导治疗决策.
科学领域:
- 神经瘤学神经瘤学
- 临床研究 临床研究
- 大脑瘤流行病学
背景情况:
- 二级质瘤 (G2-质瘤) 是一种罕见的脑瘤.
- 在RTOG9802试验中,化学辐射疗法 (CRT) 成为高风险G2质瘤 (亚总切除或年龄≥40) 的标准.
- 目前G2质瘤的现实世界治疗实践没有得到充分的记录.
研究的目的:
- 使用现实世界的数据报告G2质瘤管理的当前临床实践.
- 评估随着时间的推移使用治疗的趋势.
- 评估CRT对高风险G2质瘤患者无进展生存 (PFS) 的影响.
主要方法:
- 一个潜在的临床注册表 (BRAIN) 确定了224名G2质瘤患者,这些患者在2016年1月至2022年12月期间被诊断出G2质瘤.
- 根据RTOG9802标准,患者被分为高风险或低风险.
- 使用Kaplan-Meier方法分析了生存结果,比较了两个时间段 (TP1: 2016-2019,TP2: 2020-2022).
主要成果:
- 在186名高风险患者中,52%接受观察,34%接受CRT,10%仅接受辐射.
- CRT的使用率从TP1的22%增加到TP2的36% (p=0.004).
- 与观察相比,接受CRT的高风险患者的PFS中位数明显长 (HR 0.49,p=0.007).
结论:
- 现实数据证实,CRT在高风险G2质瘤中改善PFS,符合RTOG9802的发现.
- 尽管CRT使用量增加,但手术后的观察仍然是主要的策略.
- 验证的生物标志物对于优化G2质瘤患者管理至关重要.
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