术语治疗耐药性脑膜瘤的概念,意图和评估
Lasse Rehné Jensen1, Andrea Daniela Maier1,2, Tareq A Juratli3
1Department of Neurosurgery, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, 2100, +4524262220, Denmark.
Journal of neuro-oncology
|August 5, 2025
概括
术语"治疗阻抗性脑膜瘤"缺乏一致的定义,导致研究结果多样化. 需要标准化的标准来准确评估脑膜瘤患者的治疗.
科学领域:
- 神经瘤学神经瘤学
- 临床试验方法论 临床试验方法论
- 医学研究 医学研究
背景情况:
- 术语"治疗阻抗性脑膜瘤"被广泛使用,但缺乏标准化的诊断标准.
- 这种不一致性阻碍了研究结果的可比性和治疗疗效的评估.
- 被标记为不耐治疗的患者群体的变化需要重新评估当前的定义.
研究的目的:
- 评估被定义为治疗不耐药的患者群体的异质性.
- 探索改善定义和识别治疗耐药性脑膜瘤的一致性的建议.
- 分析不一致的定义对研究可比性和治疗评估的影响.
主要方法:
- 在2024年之前发表的69项研究的系统审查.
- 来自15个治疗不耐药患者队列 (n=211) 的个人参与者数据的分析,这些患者接受的是针对体静止素受体 (SSTR) 的向疗法.
- 与新诊断的WHO-3脑膜瘤的参考队列 (n=102) 的比较;使用Poisson回归和I2统计数据进行统计分析.
主要成果:
- 在不同研究中观察到治疗耐药性定义的显著差异.
- 在WHO-1脑膜瘤患者中,长效SSTR类似物治疗的进展 (I2 = 81.7%) 和死亡 (I2 = 74.8%) 的高跨研究变异性.
- 在治疗不耐药的WHO-2和WHO-3脑膜瘤患者中,在终点和SSTR向疗法之间更大的一致性 (I2 ≤ 16.0%);WHO等级对进展和死亡风险的显著影响.
结论:
- 不一致地应用"耐治疗"术语导致了可变的效果估计.
- 为了准确评估治疗效果,不同WHO级别的患者的组合是不可行的.
- 建议对标准化放射性评估,终点,临床核心元素和分子分类提出建议,以提高未来试验的一致性.
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