首页|弥漫内生型脑桥胶质瘤放化疗及靶向治疗单中心研究

弥漫内生型脑桥胶质瘤放化疗及靶向治疗单中心研究

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目的 探索弥漫内生型脑桥胶质瘤(DIPG)的有效治疗方法及生存影响因素.方法 回顾分析2021年4月至2024年1月首都医科大学附属北京天坛医院采用放射治疗联合替莫唑胺和尼妥珠单抗化疗或放射治疗联合ACT001化疗的14例儿童DIPG患者的临床和影像学信息及生存资料,采用Kaplan-Meier生存曲线计算中位无进展生存期和总生存期,多变量Cox比例风险回归分析各项因素对无进展生存期和总生存期的影响.结果 共14例患儿的客观缓解率为10/14,中位无进展生存期7.83个月,中位总生存期8.30个月.基线影像学无强化是无进展生存期延长的保护因素(RR=0.052,95%CI:0.006~0.416;P=0.005);男性(RR=0.085,95%CI:0.009~0.764;P=0.028)、年龄较大(RR=0.631,95%CI:0.423~0.942;P=0.024)、无脑神经受累表现(RR=0.116,95%CI:0.017~0.781;P=0.027)和基线影像学无强化(RR=0.046,95%CI:0.005~0.413;P=0.006)是总生存期延长的保护因素.结论 女性、诊断时年龄较小、发病时脑神经受累、基线影像学强化是影响DIPG患儿生存的危险因素.
Single-center study of chemoradiotherapy and targeted therapy for diffuse intrinsic pontine glioma
Objective To explore effective treatments and prognostic factors for diffuse intrinsic pontine glioma(DIPG).Methods Clinical and imaging information and survival data of 14 DIPG patients,treated with radiotherapy combined with temozolomide and nitolizumab or radiotherapy combined with ACT001,were retrospectively analysed at Beijing Tiantan Hospital,Capital Medical University from April 2021 to January 2024.The median progression free survival(PFS)and overall survival(OS)were calculated using Kaplan-Meier survival curves,and multifactorial Cox regression analysis was used to investigate the effects of different factors on PFS and OS.Results The objective response rate(ORR)was 10/14,and the median PFS and OS were 7.83 and 8.30 months,respectively.Multfactorial Cox regression analysis identified the absence of enhancement on baseline imaging as a good prognostic variable for both PFS(RR=0.052,95%CI:0.006-0.416;P=0.005)and OS(RR=0.046,95%CI:0.005-0.413;P=0.006),while male(RR=0.085,95%CI:0.009-0.764;P=0.028),older age(RR=0.631,95%CI:0.423-0.942;P=0.024),and the absence of symptoms of cranial nerve involvement at the onset(RR=0.116,95%CI:0.017-0.781;P=0.027)were also good prognostic variables for OS.Conclusions Female,younger age at diagnosis,cranial nerve involvement at the onset,and enhancement on baseline imaging are risk factors for the survival of children with DIPG.

Diffuse intrinsic pontine gliomaRadiotherapyAntineoplastic combined chemotherapy protocolsMolecular targeted therapyChild

张静、王鹏、邱晓光

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100070 首都医科大学附属北京天坛医院放疗科

100070 北京市神经外科研究所

弥漫性内生型桥脑胶质瘤 放射疗法 抗肿瘤联合化疗方案 分子靶向治疗 儿童

国家重点研发计划常见多发病防治研究专项

2023YFC2510005

2024

中国现代神经疾病杂志
中国医师协会,天津市科学技术协会,天津市神经科学学会

中国现代神经疾病杂志

CSTPCD北大核心
影响因子:0.968
ISSN:1672-6731
年,卷(期):2024.24(9)