Öz
Amaç: Ege Üniversitesi Hastanesi (EÜH) veri tabanındaki 1327 Glioblastoma (GBM) olgusunun
epidemiyolojik ve genel sağ kalım (GSK) özelliklerini istatistiksel açıdan değerlendirmektir.
Gereç Yöntem: EÜ Kanserle Savaş Uygulama ve Araştırma Merkezi (EÜKAM) tarafından 1992-2017
arasında kanser veri tabanında toplanan 117139 kanser verisi içindeki 1327 GBM olgusu
değerlendirilmiştir.
Bulgular: 1327 GBM hastası analiz edilmiştir. Tanı anı ortalama yaş 55,6 yıl bulunmuştur.
Erkek/kadın oranı 1,52:1’dir. En sık tutulumun temporal lobta (%36,3) olduğu saptanmıştır. Tedavisi
raporlanan 881 hastanın analizinde; olguların %30,2’sine yalnızca operasyon, %65,6’sına kombine
tedaviler uygulanmıştır. Otuz beş hastada (%4,0) yalnızca radyoterapi (RT) uygulanırken 558 hastada
(%63,3) kombine tedavide RT eklenmiştir. Tüm GBM hastalarının ortalama sağ kalım süresi 12,15
aydır. Bir, iki, üç ve beş yıllık GSK oranları sırasıyla %50,4, %22,02, %11 ve %5’tir. Ortalama sağ
kalım erkeklerde 11,6 ay, kadınlarda 13,3 ay olarak saptanmıştır. Cinsiyet ile sağ kalım süresi
arasında anlamlı ilişki saptanmamıştır. Yaş gruplarına göre sağ kalım analizinde ileri yaş gruplarında
sağ kalımın anlamlı olarak azaldığı saptanmıştır (p<0,001). Cerrahi, RT ve kemoterapi (KT) uygulanan
hastaların bir ve beş yıllık GSK oranının diğer tedavi şekillerine göre daha yüksek olduğu saptanmıştır
(p<0,001). Ortalama sağ kalım RT alan grupta 14,0 ay, almayanlarda ise 9,4 ay olarak bulunmuştur
(p<0,001).
Sonuçlar: Çalışmamızda tanı yaşı, eşzamanlı ve adjuvan KT (Temozolomid) tedavisi sağ kalımı
etkileyen prognostik faktörler olarak bulunmuştur. Cinsiyet ve tümör lokalizasyonu ile sağ kalım
arasında anlamlı fark saptanmamıştır. Günümüzde maksimum cerrahi rezeksiyon ve ardından
adjuvan kemoradyoterapi, GBM yönetiminin temel standardı olup, ortalama 12 aylık GSK
sağlamaktadır.
Anahtar Kelimeler
Kaynakça
- Jigisha P. Thakkar, Therese A. Dolecek, Craig Horbinski, Quinn T. Ostrom, Donita D. Lightner, Jill S. Barnholtz-Sloan, and John L. Villano1. Epidemiologic and Molecular Prognostic Review of Glioblastoma. Cancer Epidemiology, Biomarkers & Prevention 2014; DOI: 10.1158/1055-9965.EPI-14-0275.
- M Ghosh, S Shubham, K Mandal, V Trivedi, R Chauhan, S Naseera. Survival and prognostic factors for glioblastoma multiforme: Retrospective single-institutional study. Indian Journal of Cancer; 2017;54/1:362—7.
- Tomasz Tykocki, Mohamed Eltayeb. Ten-year survival in glioblastoma. A systematic review. Journal of Clinical Neuroscience 2018), https://doi.org/10.1016/j.jocn.2018.05.002.
- Roger Stupp, M.D., Warren P. Mason, M.D., Martin J. van den Bent, M.D., Michael Weller, M.D., Barbara Fisher, M.D., Martin J.B. Taphoorn, M.D., Karl Belanger, M.D., Alba A. Brandes, M.D., Christine Marosi, M.D., Ulrich Bogdahn, M.D., Jurgen Curschmann, M.D., Robert C. Janzer, M.D., Samuel K. Ludwin, M.D.,Thierry Gorlia, M.Sc., Anouk Allgeier, Ph.D., Denis Lacombe, M.D., J. Gregory Cairncross, M.D., Elizabeth Eisenhauer, M.D., and Rene O. Mirimanoff, M.D. Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma. The new england journal of medicine, 2005; 352:987-96.
- Supapan Witthayanuwat, Montien Pesee, Chunsri Supaadirek, Narudom Supakalin, Komsan Thamronganantasakul, Srichai Krusun. Survival Analysis of Glioblastoma Multiforme. Asian Pac J Cancer Prev, 2018;19(9):2613-7.
- A Report of the Medical Research Council Brain Tumour Working Party. Prognostic factors for high-grade malignant glioma: Development of a prognostic index; Journal of Neuro-Oncology, 1990;9: 47-55.
- Johnson DR, Ma DJ, Buckner JC, Hammack JE. Conditional probability of longterm survival in glioblastoma. Cancer 2012;118:5608–13. https://doi.org/ 10.1002/cncr.27590.
- Polley M-YC, Lamborn KR, Chang SM, Butowski N, Clarke JL, Prados M. Conditional probability of survival in patients with newly diagnosed glioblastoma. J Clin Oncol 2011;29:4175–80. https://doi.org/10.1200/ JCO.2010.32.4343.
- FG Davis, BJ McCarthy, S Freels, etal: The conditional probability of survival of patients with primary malignant brain tumors Cancer 85: 485– 91,1999 Crossref, Medline, Google Scholar
- Anderson E, Grant R, Lewis SC, Whittle PIR. Randomized Phase III controlled trials of therapy in malignant glioma: where are we after 40 years? Br J Neurosurg 2008;22:339–49. https://doi.org/10.1080/02688690701885603.
- Mitchell P, Ellison DW, Mendelow AD. Surgery for malignant gliomas: mechanistic reasoning and slippery statistics. Lancet Neurol 2005;4:413–22. https://doi.org/10.1016/S1474-4422 (05) 70118-6.
- Willems PWA, Taphoorn MJB, Burger H, Berkelbach van der Sprenkel JW, Tulleken CAF. Effectiveness of neuronavigation in resecting solitary intracerebral contrast-enhancing tumors: a randomized controlled trial. J Neurosurg 2006;104:360–8. https://doi.org/10.3171/jns.2006.104.3.360.
- Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007;114:97–109. (PMC free article) (PubMed) (Google Scholar).
- Abacıoğlu U, Çetin İ, Akgün Z, Şengöz M, Türk Onkoloji Dergisi, Cilt 19, Sayı 3, 2004;112-118.
Öz
Aim: The aim of this study was to evaluate the epidemiological and overall survival rates(OS) of 1327
cases of Glioblastoma (GBM) in Ege University Hospital (EÜH) database.
Materials and Methods: 1327 GBM cases were evaluated in 117139 cancer data collected from the
cancer database between 1992 and 2017 by the EU Cancer Control Application and Research Center.
Results: 1327 GBM patients were analyzed. The mean age at diagnosis was 55.6 years. The
male/female ratio was 1.52:1. The most common involvement was found in temporal lobe (36.3%).In
analysis of 881 patients whose treatment was reported. In 30.2% of the cases, only operation was
performed and in 65.6% combined treatments were applied. RT was added in 558 patients (63.3%).
The ortalama survival time of all GBM patients was 12.15 months. One, two, three and five-year OS
rates were 50.4%, 22.02%, 11% and 5% respectively. Ortalama survival was 11.6 months for males
and 13.3 months for females No significant difference was found between sex and survival time.
Survival analysis signify that survival decreased in older age groups (p<0.001).Patients who was
treated with surgery, RT and chemotherapy (CT) were found to have a higher 1 and 5-year OS rate
compared to other treatment modalities (p<0.001).Ortalama survival was 14.0 months in RT group and
9.4 months in non-RT group (p<0.001).
Conclusions: Age of diagnosis, concurrent and adjuvant chemotherapy (Temozolomide) were found
to be prognostic factors affecting survival. There was no significant difference between sex and tumor
localization and survival. Maximum surgical resection followed by adjuvant chemoradiotherapy is the
basic standard of GBM management and provides an average of 12 months OS.
Anahtar Kelimeler
Kaynakça
- Jigisha P. Thakkar, Therese A. Dolecek, Craig Horbinski, Quinn T. Ostrom, Donita D. Lightner, Jill S. Barnholtz-Sloan, and John L. Villano1. Epidemiologic and Molecular Prognostic Review of Glioblastoma. Cancer Epidemiology, Biomarkers & Prevention 2014; DOI: 10.1158/1055-9965.EPI-14-0275.
- M Ghosh, S Shubham, K Mandal, V Trivedi, R Chauhan, S Naseera. Survival and prognostic factors for glioblastoma multiforme: Retrospective single-institutional study. Indian Journal of Cancer; 2017;54/1:362—7.
- Tomasz Tykocki, Mohamed Eltayeb. Ten-year survival in glioblastoma. A systematic review. Journal of Clinical Neuroscience 2018), https://doi.org/10.1016/j.jocn.2018.05.002.
- Roger Stupp, M.D., Warren P. Mason, M.D., Martin J. van den Bent, M.D., Michael Weller, M.D., Barbara Fisher, M.D., Martin J.B. Taphoorn, M.D., Karl Belanger, M.D., Alba A. Brandes, M.D., Christine Marosi, M.D., Ulrich Bogdahn, M.D., Jurgen Curschmann, M.D., Robert C. Janzer, M.D., Samuel K. Ludwin, M.D.,Thierry Gorlia, M.Sc., Anouk Allgeier, Ph.D., Denis Lacombe, M.D., J. Gregory Cairncross, M.D., Elizabeth Eisenhauer, M.D., and Rene O. Mirimanoff, M.D. Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma. The new england journal of medicine, 2005; 352:987-96.
- Supapan Witthayanuwat, Montien Pesee, Chunsri Supaadirek, Narudom Supakalin, Komsan Thamronganantasakul, Srichai Krusun. Survival Analysis of Glioblastoma Multiforme. Asian Pac J Cancer Prev, 2018;19(9):2613-7.
- A Report of the Medical Research Council Brain Tumour Working Party. Prognostic factors for high-grade malignant glioma: Development of a prognostic index; Journal of Neuro-Oncology, 1990;9: 47-55.
- Johnson DR, Ma DJ, Buckner JC, Hammack JE. Conditional probability of longterm survival in glioblastoma. Cancer 2012;118:5608–13. https://doi.org/ 10.1002/cncr.27590.
- Polley M-YC, Lamborn KR, Chang SM, Butowski N, Clarke JL, Prados M. Conditional probability of survival in patients with newly diagnosed glioblastoma. J Clin Oncol 2011;29:4175–80. https://doi.org/10.1200/ JCO.2010.32.4343.
- FG Davis, BJ McCarthy, S Freels, etal: The conditional probability of survival of patients with primary malignant brain tumors Cancer 85: 485– 91,1999 Crossref, Medline, Google Scholar
- Anderson E, Grant R, Lewis SC, Whittle PIR. Randomized Phase III controlled trials of therapy in malignant glioma: where are we after 40 years? Br J Neurosurg 2008;22:339–49. https://doi.org/10.1080/02688690701885603.
- Mitchell P, Ellison DW, Mendelow AD. Surgery for malignant gliomas: mechanistic reasoning and slippery statistics. Lancet Neurol 2005;4:413–22. https://doi.org/10.1016/S1474-4422 (05) 70118-6.
- Willems PWA, Taphoorn MJB, Burger H, Berkelbach van der Sprenkel JW, Tulleken CAF. Effectiveness of neuronavigation in resecting solitary intracerebral contrast-enhancing tumors: a randomized controlled trial. J Neurosurg 2006;104:360–8. https://doi.org/10.3171/jns.2006.104.3.360.
- Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007;114:97–109. (PMC free article) (PubMed) (Google Scholar).
- Abacıoğlu U, Çetin İ, Akgün Z, Şengöz M, Türk Onkoloji Dergisi, Cilt 19, Sayı 3, 2004;112-118.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Ek |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2019 |
| Gönderilme Tarihi | 15 Şubat 2019 |
| Yayımlandığı Sayı | Yıl 2019 |