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털모양별아교세포종 소아환자의 부분절제술 후 치료방침 연구

Other Titles
 Radiation or Chemotherapy rather than Observation may be a Better Modality after Subtotal Resection for Pilocytic Astrocytoma in Children 
Authors
 정세용  ;  진송이  ;  한승민  ;  김효선  ;  김동석  ;  서창옥  ;  유철주  ;  한정우 
Citation
 Clinical Pediatric Hematology-Oncology, Vol.21(2) : 95-103, 2014 
Journal Title
 Clinical Pediatric Hematology-Oncology 
ISSN
 2233-5250 
Issue Date
2014
Keywords
Pilocytic astrocytoma ; Postoperative treatment ; Subtotal resection
Abstract
Background: Pilocytic astrocytoma (PA) is a low-grade glioma that occurs primarily in children and young adults. The optimal postoperative treatment modality after subtotal resection (STR) of PAs remains to be elucidated. The aim of this study was to compare the efficacies of different post-STR treatment modalities and to examine the risk factors for the progression of PAs.Methods: We reviewed the medical records of 91 pediatric PA patients in a single in-stitute during a 30-year period. Kaplan-Meier analysis was used to assess overall survival (OS) and progression-free survival (PFS), and Cox proportional hazard models were used to calculate hazard ratios.Results: The median age of 91 patients was 8.9 years (range, 0.3-17.9). GTR was per-fomed, whenever possible. Patients who underwent STR afterwards received either ra-diotherapy, chemotherapy, or were observed without further treatment, according to clinician preference. In total group, 10-year OS was 97.4% and 10-year PFS was 57.2%. In GTR group (N=33), 10-year OS and PFS was 100%. In STR group (N=49), 10-year OS was 97.7%, while 10-year PFS was 38.6%. STR group underwent following post-operative (PO) modalities; observation (PO-Obs, N=32), radiotherapy (PO-RT, N=10), chemotherapy (PO-CTx, N=7). The 10-year PFS rate was higher in patients who received postoperative treatment (either PO-RT or PO-CTx) than in patients who received PO-Obs (62.5% vs 27.0%, P=0.039). In multivariate analysis for STR group, PO-CTx (Hazard ratio (HR)=0.20, P=0.035) and PO-RTx (HR=0.13, P=0.008) were superior to observation, respectively. Conclusion: Radiation and chemotherapy are better post-STR treatment modalities than observation for pediatric PA patients.
Files in This Item:
T201404673.pdf Download
DOI
10.15264/cpho.2014.21.2.95
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Hyo Sun(김효선)
Suh, Chang Ok(서창옥)
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
Hahn, Seung Min(한승민) ORCID logo https://orcid.org/0000-0001-9832-6380
Han, Jung Woo(한정우) ORCID logo https://orcid.org/0000-0001-8936-1205
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138491
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