胶质瘤-15在肯尼亚三级医院管理的多形性胶质母细胞瘤病例回顾性审查

IF 3.7 Q1 CLINICAL NEUROLOGY Neuro-oncology advances Pub Date : 2023-10-31 DOI:10.1093/noajnl/vdad121.012
Karishma Sharma, Manel Haj Mansour
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摘要

多形性胶质母细胞瘤(GBM)是中枢神经系统最具侵袭性的肿瘤之一。虽然罕见,但它是成人中最常见的原发性脑肿瘤。尽管最近在治疗GBM患者方面取得了进展,但它预示着预后不良。撒哈拉以南非洲(SSA)关于GBM的已发表数据有限。我们对2018年1月至2020年12月期间在阿迦汗大学医院内科肿瘤科就诊的24名患者进行了回顾性图表回顾。对临床、影像学、病理结果进行调查、分析并与文献资料进行比较。在3年期间,共有24名患者在肿瘤内科诊所就诊。患者的中位年龄为54岁(IQR 44.7-65),大多数患者(>80%)为非洲裔。其中男性13例(54.2%),女性11例(45.8%)。头痛是最常见的临床表现,额叶是影像学上最常见的肿瘤部位。肿瘤中位大小为4.5cm (IQR 3.8 ~ 6.45)。确诊后,18例(75%)患者接受了最大限度的安全肿瘤切除术,13例(56%)患者在术后扫描中发现残留肿瘤。19例患者(83%)开始同步化疗(替莫唑胺)和放射治疗(CCRT)作为辅助治疗的一部分。在CCRT后开始使用替莫唑胺辅助治疗的患者中,超过三分之一的患者完成了一年的治疗。在诊断后6个月,25%的患者病情稳定,而25%的患者病情进展。我们的研究补充了文献,这些文献表明SSA合并GBM的患者年龄更小,肿瘤大小更大,但与西方患者相比,他们的治疗效果更好。需要了解肿瘤内的分子改变和更大规模的前瞻性研究来确定GBM在SSA中的行为。
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GLIOMA-15 RETROSPECTIVE REVIEW OF GLIOBLASTOMA MULTIFORME CASES MANAGED AT A TERTIARY LEVEL HOSPITAL IN KENYA
Abstract Glioblastoma Multiforme(GBM) is one of the most aggressive tumors of the central nervous system. Though rare, it accounts for the commonest primary brain tumor in adults. Despite recent advances in the treatment of patients with GBM, it portends a poor prognosis. There is limited published data of GBM from sub-Saharan Africa(SSA). We performed a retrospective chart review of 24 patients seen in the Medical Oncology service at the Aga Khan University Hospital between January 2018 and December 2020. Clinical, radiological, pathological outcomes were investigated, analyzed and compared with data from the literature. A total of twenty-four patients were seen at the medical oncology clinic over the 3-year period. The median age of the patients was 54 years (IQR 44.7-65) and majority of patients (>80%) were of African descent. Of the 24 patients, 13(54.2%) were male and 11(45.8%) were female. Headaches were the commonest clinical presentation and frontal lobe was commonest tumor location on imaging. The median size of the tumor was 4.5cm (IQR 3.8-6.45). Following diagnosis, eighteen(75%) patients underwent maximal safe resection of the tumor with presence of residual tumor in thirteen (56%) of the post-operative scans. Nineteen patients(83%) were initiated on concurrent chemotherapy (Temozolamide) and Radiation therapy (CCRT) as part of adjuvant treatment. Of those initiated on adjuvant Temozolamide following CCRT, more than one-third completed one year of treatment. At 6 months following diagnosis, 25% of patients remained stable while 25% had disease progression. Our study adds to the literature which demonstrates that patients seen in SSA with GBM present at younger age, with bigger tumor size but tend to do better compared to those in the west. Understanding of the molecular alterations within the tumor and larger prospective studies are needed to define the behavior of GBM in SSA.
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