Prognostički faktori i savremeni terapijski pristup lečenju pacijenata obolelih od multiformnog glioblastoma
Prognostic factors and modern therapeutic approach in glioblastoma multiforme treatment
Author
Ilić, Rosanda V.Mentor
Grujičić, Danica
Committee members
Džoljić, EleonoraĐurović, Branko
Nikitović, Marina
Cigić, Tomislav
Metadata
Show full item recordAbstract
Multiformni glioblastom predstavlja najčešći maligni primarni tumor mozga u odraslih.
Incidenca ovog tumora je 2 do 3 na 100 000 stanovnika godišnje u Evropi. Srednja dužina
preživljavanja je 12-18 meseci, u zavisnosti od prognostičkih parametara a stopa petogodišnjeg
preživljavanja oko 4%. U literaturi su definisani prognostički faktori koji su povezani sa dužim
preživljavanjem, a to su godine starosti pacijenta, stepen resekcije tumora kao i genski profil
tumora. Savremeni pristup lečenju ovih pacijenata predstavlja multidisciplinarni pristup, gde
operacija predstavlja samo prvi korak u lečenju, dok onkološka terapija zajedno sa intenzivnim
praćenjem i pravovremenom reoperacijom u odabranim slučajevima omogućava produžetak
preživljavanja, kao i bolji kvalitet života ovih pacijenata. Temozolomid je prvi hemioterapeutik
koji je postigao značajan pomak u preživljavanju. Srednje preživljavaje je pomereno sa 12,1 na
14,6 meseci, dok je dvogodišnje preživljavanje sa standardnim protokolom ...10,4% pomereno na
26,5%.
Ciljevi
Ciljevi ovog istraživanja obuhvataju određivanje procenta dvogodišnjeg preživljavanja, kao i
procenu faktora koji utiču na dužinu preživljavanja, određivanje značaja stepena hirurške
resekcije tumora, upoređivanje dužine preživljavanja pacijenata koji su dobijali karmustin ili
lomustin sa onima koji su bili na terapijii temozolomidom, ispitativanje uticaja reoperacije i
sekundarne hemioterapije na preživljavanje pacijenata i utvrđivanje kriterijuma za definisanje
pseudoprogresije kod pacijenata koji su dobijali zračnu terapiju konkomitantno sa
temozolomidom...
Glioblastoma multiforme is the most common malignant primary brain tumor in adults. The
incidence of this tumor is 2 to 3 per 100 000 inhabitants per year in Europe. The median survival
rate is 12-18 months, depending on the prognostic parameters, and the five-year survival rate is
about 4%. The literature defines prognostic factors that are associated with longer survival,
which are the age of the patient, the degree of tumor resection, and genetic profile of the tumor.
The modern approach to the treatment of these patients is a multidisciplinary approach, where
the operation is only the first step in the treatment, while oncological therapy, together with
intensive monitoring and timely reoperation in selected cases, allows an extension of survival as
well as a better quality of life for these patients. Temozolomide is the first chemotherapeutic who
has made significant progress in survival. Mean survival was shifted from 12.1 to 14.6 months,
while two-year survival with a standard p...rotocol of 10.4% was shifted to 26.5%.
Aims
The objectives of this study include determining the percentage of two-year survival, as well as
assessing the factors that influence the survival rate, determining the significance of the degree
of surgical tumor resection, comparing the length of survival of patients who received carmustin
or lomustin with those who were on therapy with temozolomide, examining the effect of the
reoperation and secondary chemotherapy on survival of patients and determination of criteria for
defining pseudoprogression in patients receiving radiotherapy concomitant with temozolomide.
Methodology
In the period from January 2010 to December 2012, 110 patients with newly diagnosed
glioblastoma were operated on Neurooncology department. The data were collected
prospectively, recorded in the electronic database, and subsequently analyzed retrospectively...