Prediction of treatment results of low-grade gliomas of the cerebral hemispheres.
DOI:
https://doi.org/10.26641/2307-0404.2017.3.111926Ключові слова:
low-grade gliomas, anaplastic astrocytoma, glioblastoma, surgery, gross-total resection, adjuvant therapy, survival, Kaplan-MeierАнотація
Glial tumors are the most common primary neoplasms of the central nervous system. Their proportion in the total structure of primary brain tumors is 50-65%. In Ukraine, according to the statistical data of the cancer-registry of the year 2014, 49,3% of patients with primary diagnosed malignant neoplasms of the brain did not live for one year. The aim of the study was to improve the survival rates of patients with low-grade glial tumors (LGT) (grade III-IV) by determining optimal treatment strategy and main prognostic survival factors. A prospective study of the results of treatment of patients with LGT from 2009 to 2014 was conducted. The study consistently included 100 operated patients with LGT (anaplastic astrocytoma (AA) and glioblastoma (GLB)). The median survival in the total group of patients (n=100) was 363.5 days (12 months). The main statistically significant prognostic factors of survival were: the completeness of tumor removal (p=0.00000000007) and the character of adjuvant therapy (p=0.000012). With the removal of LGT III-IV grade aplasias, which do not spread to functionally important areas and deep areas of the brain, one should try to perform Gross-total resection (GTR), which ensures long-term survival. The median survival of patients after GTR was 22.3 months. An integrated approach to the treatment which includes surgery, adjuvant radiotherapy and monochemotherapy with temozolamide showed the best survival rates – 20.5 months.
Посилання
Glavatsky O, Butrym O. [Effect of a surgical component to the results of radiotherapy and chemo-therapy of gliomas of the brain]. Ukrayinskyy medychnyy almanakh. 2011;14(3):56-57. Ukrainian.
Truskavetsky DL,KishOV, Kochmar MYu, Loshak MYa. [Diagnosis of glial brain tumors using CT]. Nauk. visn. Uzhgor. univer. 2013;3(48):258-64. Ukrainian.
Smolin AV, Bekyashev AH, Kobyakov GL, et al. [The first results of the Russian multicentre study on the epidemiology of malignant gliomas]. Sovremennaja onkologija. 2014;2(16):50-55. Russian.
Sirko AG, Zorin NA, Novik YuE, et al. [Stealth Station® Treon®Plus neuronavigation system in surgery of intracranial meningioma]. Ukrainian Neurosurgical Journal. 2010;1:39-46. Russian.
Fedorenko ZP, Mykhaylovych YuY, Hulak LO, et al. [Cancer inUkraine, 2014-2015 Morbidity, mortality, cancer service performance]. Bulletin of National Cancer Registry ofUkraine. 2016;17. Ukrainian.
Rozumenko VD, Yavorski AA [Dynamics of survival of elderly Patients with glial tumors of the brain hemispheres]. Ukrayinskyy zhurnal maloinvazyvnoyi ta endoskopichnoyi khirurhiyi. 2014;18(4):13-15. Ukrainian.
Zozulya YuP, Glavatsky OYa, Vasylyeva IH,ChopykNH. [Current aspects of chemotherapy of glial brain tumors]. Zhur. NAMN Ukr. 2015;2:158-169. Ukrainian.
Chomolyak Yu, Smolanka V, Studenyak T. [Outlook for the treatment and prognosis of high-grade brain gliomas]. Ukrainian Neurosurgical Journal. 2013;3:4-9. Ukrainian.
Pedicini P, Fiorentino A, Simeon V, et al. Clinical radiobiology of glioblastoma multiforme: estimation of tumor control probability from various radiotherapy fractionation schemes. Strahlenther Onkol. 2014;190(10):925-32. PMID: 24699988. doi: 10.1007/s00066-014-0638-9.
Eyüpoglu IY, Buchfelder M, Savaskan NE. Surgical resection of malignant gliomas-role in optimizing patient outcome. Nat. Rev. Neurol. 2013;9(3):141-51. PMID: 23358480. doi: 10.1038/nrneurol.2012.279.
Stupp R, Mason WP, Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. New Engl. J. Med. 2005;352:987-996. PMID: 15758009. doi: 10.1056/NEJMoa043330.
Altekruse SF, Kosary CL, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2007.Bethesda,Md: National Cancer Institute. 2010.
Esquenazi Y, Friedman E, Liu Z, et al. The Survival Advantage of "Supratotal" Resection of Glioblastoma Using Selective Cortical Mapping and the Subpial technique. Neurosurgery. 2017; nyw174. PMID: 28368547. doi: https://doi.org/10.1093/neuros/nyw174.
Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;6(131):803-20. PMID: 27157931. doi: 10.1007/s00401-016-1545-1.
##submission.downloads##
Як цитувати
Номер
Розділ
Ліцензія
Авторське право (c) 2017 Медичні перспективи
Ця робота ліцензується відповідно до Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.
