BibTex RIS Kaynak Göster

Yıl 2012, Cilt: 34 Sayı: 3, 279 - 288, 22.05.2012

Birsen Yücel Ebru Atasever Akkaş , Eda Erdiş , Yıllar Okur Mehmet Eren , Nalan Babacan , Turgut Kaçan , Saadettin Kılıçkap

Öz

Kaynakça

  • Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ. Cancer statistics, 2005. CA Cancer J Clin 2005; 55: 10-30.
  • Shaw EG, Debinski W, Robbins ME. Central nervous system tumors. Gunderson LL, Tepper JE (ed.) Clinical Radiation Oncology (2th.). Elsevier, Philadelphia 2007; 2: 459-91.
  • Davis FG, Freels S, Grutsch J, Barlas S, Brem S. Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973-1991. J Neurosurg 1998; 88: 1-10.
  • Siker ML, Donahue BR, Vogelbaum MA, Tome WA, GilbertMR, Mehta MP. Primary Intracranial Neoplasms. Halperin EC, Perez CA, Brady LW (ed.). Principles and Practice of Radiation Oncology (5th). Lippincott Williams & Wilkins, Philadelphia 2008: 32: 717-49.
  • Davis FG, McCarthy BJ, Freels S, Kupelian V, Bondy ML. The conditional probability of survival of patients with primary malignant brain tumors: surveillance, epidemiology, and end results (SEER) data. Cancer 1999; 85: 485- 91.
  • Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, Weller M, Kros JM, Hainfellner JA, Mason W, Mariani L, Bromberg JE, Hau P, Mirimanoff RO, Cairncross JG, Janzer RC, Stupp R. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005; 352: 997-1003.
  • Central Brain Tumor Registry of the United States. Statistical Report: Primary Brain Tumors in the United States, 1998-2002. Hinsdale, IL: CBTRUS; 2005. Available 03.09.2012) (Erişim tarihi:
  • Curran WJ Jr, Scott CB, Horton J, Nelson JS, Weinstein AS, Fischbach AJ, Chang CH, Rotman M, Asbell SO, Krisch RE, Nelson DF.. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst 1993; 85: 704-10.
  • Coons SW, Johnson PC, Pearl DK. The prognostic significance of Ki-67 labeling indices for oligodendrogliomas. Neurosurgery 1997; 41: 878-85.
  • McGuire CS, Sainani KL, Fisher PG. Both Location and Age Predict Survival in Ependymoma: A SEER Study. Pediatr Blood Cancer 2009; 52: 65-9.
  • Karim AB, Maat B, Hatlevoll R, Menten J, Rutten EH, Thomas DG, Mascarenhas F, Horiot JC, Parvinen LM, van Reijn M, Jager JJ, Fabrini MG, van Alphen AM, Hamers HP, Gaspar L, Noordman E, Pierart M, van Glabbeke M. A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) Study 22844. Int J Radiat Oncol Biol Phys 1996; 36: 549-56.
  • Macdonald DR. Low-grade gliomas, mixed gliomas, and oligodendrogliomas. Semin Oncol 1994; 21: 236-48.
  • Bruner JM. Neuropathology of malignant gliomas. Semin Oncol 1994; 21: 126- 38.
  • Bozdoğan N, Erden E, Atasoy P, Tun K, Savaş A. Glial tümörlerde proliferasyon markerlerinin prognostik önemi. Türk Nöroşirürji Dergisi 2000; 10: 11-5.
  • Chang CH, Horton J, Schoenfeld D, Salazer O, Perez-Tamayo R, Kramer S, Weinstein A, Nelson JS, Tsukada Y. Comparison of postoperative radiotherapy and combined postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. A joint Radiation Therapy Oncology Group and Eastern Cooperative Oncology Group study. Cancer 1983; 52: 997-1007.
  • Hulshof MC, Schimmel EC, Andries Bosch D, González González D. Hypofractionation in glioblastoma multiforme. Radiother Oncol 2000; 54: 143-8.
  • Karamitopoulou E, Perentes E, Diamantis I, Maraziotis T. Ki-67 immunoreactivity in human central nervous system tumors: a study with MIB 1 monoclonal antibody on archival material. Acta Neuropathol 1994; 87: 47-54.
  • Kılıçoğlu MK, Tolunay Ş, Ferik Z, Elezoğlu B, Aşık N, Korfalı E, Bekar A, Kocaeli H, Taşkapılıoğlu Ö. Epandimomlarda Ki-67 ekspresyonunun histopatolojik parametreler ile ilişkisi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2011; 37: 93-7.
  • Burger PC, Scheithauer BW, Vogel FS. Surgical pathology of the nervous system and its coverings. 4th edition. Philadelphia: Churchill Livingstone; 2002; 241-54.
  • Simpson JR, Horton J, Scott C, Curran WJ, Rubin P, Fischbach J, Isaacson S, Rotman M, Asbell SO, Nelson JS, Weinstein AS, Nelson DF. Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: Results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys 1993; 26: 239-44.
  • Pignatti F, van den Bent M, Curran D, Debruyne C, Sylvester R, Therasse P, Afra D, Cornu P, Bolla M, Vecht C, Karim AB; European Organization for Research and Treatment of Cancer Brain Tumor Cooperative Group; European Organization for Research and Treatment of Cancer Radiotherapy Cooperative Group. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol 2002; 20: 2076-84.
  • Safdari H, Fuentes JM, Dubois JB, Alirezai M, Castan P, Vlahovitch B. Radiation necrosis of the brain: Time of onset and incidence related to total dose and fractionation of radiation. Neuroradiology 1985; 27: 44-7.
  • Kumar AJ, Leeds NE, Fuller GN, Van Tassel P, Maor MH, Sawaya RE, Levin VA. Malignant gliomas: MR imaging spectrum of radiation therapy- and chemotherapy-induced necrosis of the brain after treatment. Radiology 2000; 217: 377-84.

Beyin tümörlü hastaların radyoterapi sonrası retrospektif değerlendirilmesi

Yıl 2012, Cilt: 34 Sayı: 3, 279 - 288, 22.05.2012

Birsen Yücel Ebru Atasever Akkaş , Eda Erdiş , Yıllar Okur Mehmet Eren , Nalan Babacan , Turgut Kaçan , Saadettin Kılıçkap

Öz

Amaç. Bu çalışmada, adjuvan radyoterapi veya kemoradyoterapi ile tedavi edilen beyin tümörlü
hastaların sağkalım analizi, tedavi yan etkileri ve sağkalımı etkileyen prognostik faktörlerin
incelemesi amaçlandı. Yöntem. Çalışmada Cumhuriyet Üniversitesi Tıp Fakültesi Araştırma ve
Uygulama Hastanesi Onkoloji Merkezinde takip edilen 76 beyin tümörlü hasta verileri retrospektif
olarak incelendi. Bulgular. Elli bir (%67) erkek, 25 (%33) kadın toplam 76 hasta çalışmaya dahil
edildi. Histopatolojik olarak: 18'inde (%24) düşük gradeli glial tümör, 17'sinde (%22) yüksek
gradeli glial tümör, 33'ünde (%44) glioblastoma multiforme, 4'ünde (%5) hipofiz adenomu ve
4'ünde (%5) medullablastom bulunmaktaydı. Ortanca takip süresi 16 ay (1-199 ay) idi. İki yıllık
genel sağkalım ve 2 yıllık hastalıksız sağkalım: düşük gradeli glial tümörlerde sırasıyla %83 ve
%83, yüksek gradeli glial tümörlerde %46 ve %40, glioblastoma multiforme hastalarında %28 ve
%24 olarak tespit edildi. Tek değişkenli analizde hastaların genel sağkalımını, histopatoloji
( < 0,001), yaş (≤50 ve > 50, p < 0,001), grade (p:0,003), Ki-67 değeri (≤10 ve > 10, p: 0,016), Eastern
Cooperative Oncology Group performans durumu (p:0,006) ve cerrahi (biopsi ile total rezeksiyon
karşılaştırıldığında p:0,017) etkiledi. Çok değişkenli analizde ise grade (p: 0,013), yaş (p:0,025) ve
Eastern Cooperative Oncology Group performans durumu (p < 0,001) sağkalımı bağımsız olarak
etkileyen prognostik faktörlerdi. Akut yan etki olarak en sık 51 (%67) hastada baş ağrısı, 32 (%42)
hastada bulantı-kusma görüldü. Radyoterapi nekrozu 3 (%5) hastada da teşhis edildi. Sonuç. Bu
çalışmada, glioblastoma multiforme ve yüksek gradeli glial tümörlerde genel ve hastalıksız
sağkalım düşük gradeli glial tümörler hariç literatür ile benzer sonuçlar göstermektedir. Bu hasta
grubunun en önemli prognostik faktörleri ise grade, yaş ve Eastern Cooperative Oncology Group
performans durumu olarak belirlendi.

Anahtar Kelimeler

Beyin tümörü sağkalım prognoz

Kaynakça

  • Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ. Cancer statistics, 2005. CA Cancer J Clin 2005; 55: 10-30.
  • Shaw EG, Debinski W, Robbins ME. Central nervous system tumors. Gunderson LL, Tepper JE (ed.) Clinical Radiation Oncology (2th.). Elsevier, Philadelphia 2007; 2: 459-91.
  • Davis FG, Freels S, Grutsch J, Barlas S, Brem S. Survival rates in patients with primary malignant brain tumors stratified by patient age and tumor histological type: an analysis based on Surveillance, Epidemiology, and End Results (SEER) data, 1973-1991. J Neurosurg 1998; 88: 1-10.
  • Siker ML, Donahue BR, Vogelbaum MA, Tome WA, GilbertMR, Mehta MP. Primary Intracranial Neoplasms. Halperin EC, Perez CA, Brady LW (ed.). Principles and Practice of Radiation Oncology (5th). Lippincott Williams & Wilkins, Philadelphia 2008: 32: 717-49.
  • Davis FG, McCarthy BJ, Freels S, Kupelian V, Bondy ML. The conditional probability of survival of patients with primary malignant brain tumors: surveillance, epidemiology, and end results (SEER) data. Cancer 1999; 85: 485- 91.
  • Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, Weller M, Kros JM, Hainfellner JA, Mason W, Mariani L, Bromberg JE, Hau P, Mirimanoff RO, Cairncross JG, Janzer RC, Stupp R. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005; 352: 997-1003.
  • Central Brain Tumor Registry of the United States. Statistical Report: Primary Brain Tumors in the United States, 1998-2002. Hinsdale, IL: CBTRUS; 2005. Available 03.09.2012) (Erişim tarihi:
  • Curran WJ Jr, Scott CB, Horton J, Nelson JS, Weinstein AS, Fischbach AJ, Chang CH, Rotman M, Asbell SO, Krisch RE, Nelson DF.. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst 1993; 85: 704-10.
  • Coons SW, Johnson PC, Pearl DK. The prognostic significance of Ki-67 labeling indices for oligodendrogliomas. Neurosurgery 1997; 41: 878-85.
  • McGuire CS, Sainani KL, Fisher PG. Both Location and Age Predict Survival in Ependymoma: A SEER Study. Pediatr Blood Cancer 2009; 52: 65-9.
  • Karim AB, Maat B, Hatlevoll R, Menten J, Rutten EH, Thomas DG, Mascarenhas F, Horiot JC, Parvinen LM, van Reijn M, Jager JJ, Fabrini MG, van Alphen AM, Hamers HP, Gaspar L, Noordman E, Pierart M, van Glabbeke M. A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) Study 22844. Int J Radiat Oncol Biol Phys 1996; 36: 549-56.
  • Macdonald DR. Low-grade gliomas, mixed gliomas, and oligodendrogliomas. Semin Oncol 1994; 21: 236-48.
  • Bruner JM. Neuropathology of malignant gliomas. Semin Oncol 1994; 21: 126- 38.
  • Bozdoğan N, Erden E, Atasoy P, Tun K, Savaş A. Glial tümörlerde proliferasyon markerlerinin prognostik önemi. Türk Nöroşirürji Dergisi 2000; 10: 11-5.
  • Chang CH, Horton J, Schoenfeld D, Salazer O, Perez-Tamayo R, Kramer S, Weinstein A, Nelson JS, Tsukada Y. Comparison of postoperative radiotherapy and combined postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. A joint Radiation Therapy Oncology Group and Eastern Cooperative Oncology Group study. Cancer 1983; 52: 997-1007.
  • Hulshof MC, Schimmel EC, Andries Bosch D, González González D. Hypofractionation in glioblastoma multiforme. Radiother Oncol 2000; 54: 143-8.
  • Karamitopoulou E, Perentes E, Diamantis I, Maraziotis T. Ki-67 immunoreactivity in human central nervous system tumors: a study with MIB 1 monoclonal antibody on archival material. Acta Neuropathol 1994; 87: 47-54.
  • Kılıçoğlu MK, Tolunay Ş, Ferik Z, Elezoğlu B, Aşık N, Korfalı E, Bekar A, Kocaeli H, Taşkapılıoğlu Ö. Epandimomlarda Ki-67 ekspresyonunun histopatolojik parametreler ile ilişkisi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2011; 37: 93-7.
  • Burger PC, Scheithauer BW, Vogel FS. Surgical pathology of the nervous system and its coverings. 4th edition. Philadelphia: Churchill Livingstone; 2002; 241-54.
  • Simpson JR, Horton J, Scott C, Curran WJ, Rubin P, Fischbach J, Isaacson S, Rotman M, Asbell SO, Nelson JS, Weinstein AS, Nelson DF. Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: Results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys 1993; 26: 239-44.
  • Pignatti F, van den Bent M, Curran D, Debruyne C, Sylvester R, Therasse P, Afra D, Cornu P, Bolla M, Vecht C, Karim AB; European Organization for Research and Treatment of Cancer Brain Tumor Cooperative Group; European Organization for Research and Treatment of Cancer Radiotherapy Cooperative Group. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol 2002; 20: 2076-84.
  • Safdari H, Fuentes JM, Dubois JB, Alirezai M, Castan P, Vlahovitch B. Radiation necrosis of the brain: Time of onset and incidence related to total dose and fractionation of radiation. Neuroradiology 1985; 27: 44-7.
  • Kumar AJ, Leeds NE, Fuller GN, Van Tassel P, Maor MH, Sawaya RE, Levin VA. Malignant gliomas: MR imaging spectrum of radiation therapy- and chemotherapy-induced necrosis of the brain after treatment. Radiology 2000; 217: 377-84.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Dahili Tıp Bilimleri Araştırma Yazıları
Yazarlar

Birsen Yücel

Ebru Atasever Akkaş

Eda Erdiş

Yıllar Okur

Mehmet Eren

Nalan Babacan

Turgut Kaçan

Saadettin Kılıçkap

Yayımlanma Tarihi 22 Mayıs 2012
Yayımlandığı Sayı Yıl 2012Cilt: 34 Sayı: 3

Kaynak Göster

AMA Yücel B, Atasever Akkaş E, Erdiş E, Okur Y, Eren M, Babacan N, Kaçan T, Kılıçkap S. Beyin tümörlü hastaların radyoterapi sonrası retrospektif değerlendirilmesi. CMJ. Aralık 2012;34(3):279-288.