Risk Factors for Malignant Transformation of Low-Grade Glioma
作者： Erin S. Murphy , Charles M. Leyrer , Michael Parsons , John H. Suh , Samuel T. Chao
DOI: 10.1016/J.IJROBP.2017.12.258
关键词: Medicine 、 Internal medicine 、 Progression-free survival 、 Young adult 、 Oncology 、 Multivariate analysis 、 Proportional hazards model 、 Incidence (epidemiology) 、 Glioma 、 Chi-squared distribution 、 Temozolomide
摘要: Purpose The incidence, risk factors, and outcomes of low-grade glioma patients who undergo malignant transformation (MT) in the era temozolomide are not well known. This study evaluates these factors a large group World Health Organization grade 2 treated at tertiary-care institution. Methods Materials Patient, tumor, treatment were analyzed using an institutional review board–approved database. Characteristics compared χ Wilcoxon signed rank tests. Time to event was summarized proportional hazards models. Univariate multivariate survival analyses performed. Results Of total 599 patients, 124 underwent MT; 76 (61.3%) had biopsy-proven MT. MT incidence 21%, median time 56.4 months. 5- and 10-year progression-free rates 30.6% ± 4.2% 4.8% ± 1.9%, respectively, for 60% ± 2.4% 38% ± 2.7%, non-MT patients. 5- overall 75% ± 4.0% 46% ± 5.0%, 87% ± 1.7% 78% ± 2.3%, On analysis, older age ( P = .001), male sex .004), multiple tumor locations chemotherapy alone .012), extent resection .045) remained significant predictors Conclusions affects survival. Risk include age, sex, locations, use alone, presence residual disease. Our finding that initial interventions could affect rate is provocative, but data should be validated from prospective trials. In addition improving survival, future therapeutic efforts focus on preventing
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