文章：

卡莫司汀晶片植入治疗进展性高级别胶质瘤是否是一种相关治疗选择？一项53例病例系列中的并发症发生率、并发症预测因素及肿瘤功能预后分析

Is Carmustine Wafer Implantation in Progressive High-Grade Gliomas a Relevant Therapeutic Option? Complication Rate, Predictors of Complications and Onco-Functional Outcomes in a Series of 53 Cases

原文发布日期：12 October 2024

DOI: 10.3390/cancers16203465

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: The aim was to determine the complication rate and the predictors of complications and survival in high-grade glioma surgically managed at progression with implantation of Carmustine wafers.Methods: A retrospective series of 53 consecutive patients operated on between 2017 and 2022 was built.Results: The median age was 55 ± 10.9 years. The rates of global and infectious complications were 35.8% and 18.9%, respectively. In multivariate analysis, patients with a preoperative neurological deficit were more prone to develop a postoperative complication (HR = 5.35 95% CI 1.49–19.26,p= 0.01). No predictor of infectious complication was identified. In the grade 4 glioma subgroup (n = 44), progression-free and overall survival (calculated starting from the reresection) reached 3.95 months, 95% CI 2.92–5.21 and 11.51 months, 95% CI 9.11–17.18, respectively. Preoperative KPS > 80% (HR = 0.97 95% CI 0.93–0.99,p= 0.04), Gross Total Resection (HR = 0.38 95% CI 0.18–0.80,p= 0.01), and 3-month postoperative KPS > 80% (HR = 0.35 95% CI 0.17–0.72,p= 0.004) were predictors of prolonged overall survival.Conclusions: Surgical resection is a relevant option in high-grade gliomas at progression, especially in patients with a preoperative KPS > 80%, without preoperative neurological deficit, and amenable to complete resection. In patients elected for surgery, Carmustine wafer implantation is associated with a high rate of complications. It is consequently critical to closely monitor the patients for whom this option is chosen.

摘要翻译： 

背景/目的：本研究旨在评估高级别胶质瘤进展期手术植入卡莫司汀晶片治疗的并发症发生率，以及并发症与生存期的预测因素。方法：回顾性纳入2017年至2022年间连续接受手术的53例患者。结果：患者中位年龄为55±10.9岁。总体并发症发生率为35.8%，感染性并发症发生率为18.9%。多因素分析显示，术前存在神经功能缺损的患者术后发生并发症的风险更高（HR=5.35，95% CI 1.49–19.26，p=0.01）。未发现感染性并发症的显著预测因素。在4级胶质瘤亚组（n=44）中，自再次手术起计算的无进展生存期和总生存期分别为3.95个月（95% CI 2.92–5.21）和11.51个月（95% CI 9.11–17.18）。术前KPS评分>80%（HR=0.97，95% CI 0.93–0.99，p=0.04）、肿瘤全切除（HR=0.38，95% CI 0.18–0.80，p=0.01）以及术后3个月KPS评分>80%（HR=0.35，95% CI 0.17–0.72，p=0.004）是延长总生存期的预测因素。结论：手术切除是高级别胶质瘤进展期的可行治疗选择，尤其适用于术前KPS评分>80%、无神经功能缺损且可实现完全切除的患者。对于选择手术的患者，卡莫司汀晶片植入与较高的并发症发生率相关，因此需对接受该治疗方案的患者进行密切监测。

原文链接：

Is Carmustine Wafer Implantation in Progressive High-Grade Gliomas a Relevant Therapeutic Option? Complication Rate, Predictors of Complications and Onco-Functional Outcomes in a Series of 53 Cases