Prognostic Factors Affecting the Outcome in Glioblastoma Multiforme: A Single Institution Experience

影響多型性膠狀母細胞瘤治療結果之預後因子：我們的經驗

黃家俊(Chia-Chun Huang) ； 劉幕台(Mu-Tai Liu) ； 畢祖平(Chu-Ping Pi) ； 張東浩(Tung-Hao Chang) ； 黃昭源(Chao-Yuan Huang)

《放射治療與腫瘤學》 19卷1期 (2012/03) Pp. 21-29

https://doi.org/10.6316/TRO/201219(1)21

摘要

目的：多型性膠狀母細胞瘤是發生於成年人最惡性的原發性腦腫瘤，在此篇文章中，我們報告了治療多型性膠狀母細胞瘤的經驗並分析預後因子。材料與方法：自1998年4月至2010年8月，在本院有30例接受腫瘤切除和放射治療並接受化學治療（或無）的多型性膠狀母細胞瘤病人。其中16例患者為男性（53%），14例為女性（47%）。年齡中位數為61歲。在日常體能狀態方面，卡式量表大於70分為19例（63%），小於70分為11例（37%）。腫瘤大小中位數為5.0公分。所有患者在術後均接受放射治療併化學治療（或無）。放射治療劑量中位數為5940 cGy，有13位病人（43%）接受化學治療。化療處方藥物包括ACNU、BCNU與Temozolomide。追蹤期間為1.2至49.3個月（中位數為10.4個月)。結果：治療結束後有8位病人（27%）有腫瘤治療反應，19位病人（63%）的疾病呈現惡化狀態，而3位病人（10%）則為疾病穩定狀態。存活時間中位數為10.4個月。在最後一次追蹤時有5位病人（17%）存活，25位病人（83%）死亡。一年的整體存活率為49%，而2年整體存活率為17%。日常體能狀態是一個重要的預後因子（p= 0.008, log-rank test；p= 0.025，Cox proportional hazards model）。結論：儘管治療進步，多型性膠狀母細胞瘤的預後仍舊不佳，治療反應不佳與局部復發仍是影響多型性膠狀母細胞瘤預後的主要因素。必須要有更有效的治療以期改善治療結果與預後。

關鍵字

腦部腫瘤 ； 多型性膠狀母細胞瘤 ； 放射線治療 ； 帝盟多

並列摘要

Purpose: Glioblastoma multilorme (GBM) is the most malignant primary brain tumor in adults, Here we presented our institution experience of treatment resu1ts in Taiwan GBM patients and analyzed the prognostic factors. Materials and Methods: From Apri1 1998 to August 2010, 30 patients with GBM received tumor excision and radiotherapy with/without chemotherapy in our institution. Sixteen patients were ma1e (53%), and 14 were female (47%). The median age was 61 years. The performances status of Karnofsky Performance Sca1e was ≥70 in 19 patients (63%), and ＜70 in 11 patients (37%). The median size of tumor was 5.0 cm. All patients had definitive or post-operative adjuvant radiotherapy with/without chemotherapy. The median total radiation dose was 5940 cGy. Thirteen patients (43%) received chemotherapy. The chemotherapy regimens included ACNU, BCNU and Temozolomide. The follow-up period ranged from 1.2 to 49.3 months (median, 10.4 months) Results: Eight patients (27%) had tumor response after treatments, 19 patients (63%) had progression of disease, and 3 patients (10%) had stable disease. The median survival duration was 10.4 months. Five patients (17%) were alive and 25 patients (83%) were dead at the 1ast 101l0w-up. The 1-year overall surviva1 was 49%, and the 2-year overall survival was 17%. Performance status was a statistically significant factor for overall surviva1 (p= 0.008, log-rank test; p= 0.025, Cox proportiona1 hazards model). Conclusion: Despite recent therapeutic advances, the prognosis of GBM remains poor. Poor response to current therapies and loco-regional recurrence still were the main failure patterns for GBM. A large series of more patients with longer follow-up and more effective treatments is warranted.

並列關鍵字

Brain tumor ； Glioblastoma multiforme ； Radiotherapy ； Temozolomide