胶质母细胞瘤的复发模式及相关因素分析  

Analysis of recurrence patterns and associated factors of glioblastoma

作　　者：寻姝姝 刘宏博 丁晓[3] 陆海军[1] XUN Shushu;LIU Hongbo;DING Xiao;LU Haijun(Department of Radiotherapy,the Affiliated Hospital of Qingdao University,Shandong Qingdao 266000,China;Department of Oncology,Jinxiang People's Hospital of Shandong Province,Shandong Jinxiang 272000,China;Department of Stomatology,the Affiliated Hospital of Qingdao University,Shandong Qingdao 266000,China)

机构地区：[1]青岛大学附属医院放疗科,山东青岛266000 [2]山东省金乡县人民医院肿瘤科,山东金乡272000 [3]青岛大学附属医院口腔科,山东青岛266000

出　　处：《现代肿瘤医学》2024年第12期2203-2208,共6页Journal of Modern Oncology

摘　　要：目的:探究手术后胶质母细胞瘤(glioblastoma, GBM)的复发模式及预后影响因素。方法:回顾性收集并分析2017年01月至2020年12月期间就诊于我院的105例胶质母细胞瘤患者的资料,基于连续的影像学表现将肿瘤复发模式划分为局部复发及非局部复发。进一步收集患者的临床及病理特征,分析不同复发模式的影响因素。结果:这项单中心回顾性研究包括105例手术切除后的胶质母细胞瘤患者。所有患者的中位无进展生存期(progression-free survival, PFS)为9.8个月;中位总生存期(overall survival, OS)为22.8个月。在49例(67.1%)和24例(32.9%)患者中观察到局部和非局部复发模式。73例复发患者中局部复发患者的中位PFS为4.8个月,非局部复发的患者为9.9个月(P=0.045)。未观察到OS与复发模式之间的相关性(P=0.242)。单因素回归分析示病灶部位(P=0.002)、室管膜下区受侵犯情况(P=0.009)、MGMT启动子甲基化状况(P=0.013)、 TERT启动子突变状况(P=0.031)、化疗与否(P=0.000)与PFS相关;病灶部位(P=0.003)、化疗与否(P=0.001)、放疗完成与否(P=0.004)与患者的OS相关。多因素Cox回归分析示病灶部位(P=0.035)、室管膜下区受侵犯情况(P=0.026)、化疗与否(P=0.036)和MGMT启动子甲基化(P=0.049)为PFS的独立影响因素;化疗与否(P=0.005)及放疗完成与否(P=0.005)是影响OS的独立危险因素。结论:GBM主要复发在局部,PFS较短。不同的临床和分子特征可以影响患者的预后,为医生提供理论参考,以做出更个性化和精确的治疗决策。Objective:To investigate the recurrence patterns and prognostic factors of glioblastoma(GBM)after surgery.Method:We retrospectively collected and analyzed data from 105 patients diagnosed with GBM at our institution between January 2017 and December 2020.Recurrence patterns were categorized into local and non-local based on sequential imaging findings.Additionally,we compiled clinical and pathological data for these patients to identify factors that may influence the distinct patterns of tumor recurrence.Results:This single-center retrospective study included 105 patients with GBM who underwent surgical resection.The median progression-free survival(PFS)for all patients was 9.8 months.The median overall survival(OS)was 22.8 months.Local and non-local recurrence patterns were observed in 49(67.1%)and 24(32.9%)patients,respectively.Among the 73 patients with recurrences,those with local recurrence had a median PFS of 4.8 months,while those with non-local recurrence had a median PFS of 9.9 months(P=0.045).No correlation between OS and pattern of recurrence was observed(P=0.242).Univariate regression analysis showed that laterality(P=0.002),subventricular zone involvement(P=0.009),MGMT promoter methylation status(P=0.013),TERT promoter mutation status(P=0.031),and chemotherapy or not(P=0.000)were associated with PFS.The laterality(P=0.003),chemotherapy or not(P=0.001),and radiotherapy or not(P=0.004)were related to patient OS.Multivariable Cox regression analysis indicated that laterality(P=0.035),subventricular zone involvement(P=0.026),chemotherapy or not(P=0.036),and MGMT promoter methylation status(P=0.049)were independent factors affecting PFS.The chemotherapy or not(P=0.005)and radiotherapy or not(P=0.005)were independent risk factors impacting OS.Conclusion:GBM primarily recurs locally,with a shorter PFS.Different clinical and molecular characteristics can influence patient prognosis,providing theoretical references for physicians to make more personalized and precise treatment decisions.

关 键 词：胶质母细胞瘤 复发模式 预后 分子指标 

分 类 号：R737.9[医药卫生—肿瘤]