PO.CL09.02 · 临床研究
2000年至2020年美国胶质母细胞瘤患者治疗与生存趋势：一项基于人群的SEER分析
Trends in treatment and survival among patients with glioblastoma in the United States, 2000 to 2020: A population-based SEER analysis
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：胶质母细胞瘤初始治疗组合在真实世界中应用的人群水平模式仍鲜有明确表征。我们评估了二十年间治疗采用的全国趋势，并检验了它们与生存结局的关联。
方法：我们评估了SEER登记处中46,186例胶质母细胞瘤患者在治疗和生存方面的时间趋势（2000-2020年）。用逻辑回归对治疗利用进行建模，用Cox回归估计生存。
结果：在46,186例患者中（50.0%年龄40-65岁；43.0%年龄≥65岁；58.0%男性），43.5%接受了全切除术（GTR），32.0%接受了次全切除，24.5%未手术；71.8%接受了放疗，61.3%接受了化疗。从2000年到2020年，任何手术（OR/年1.03，95% CI 1.028-1.036）、放疗（1.01，1.010-1.017）和化疗（1.08，1.081-1.088）的利用率均有所增加，而GTR相对于次全切除的可能性下降（0.92，0.915-0.922）。三联疗法适度增加（1.01，1.005-1.012），但在30%处趋于平稳。年龄较大、非脑叶肿瘤、未婚状态和较低收入预示三联疗法几率较低；校正后，日历年份显示出边际下降（aOR/年0.99，0.99-1.00）。中位总生存从6.0个月改善至10.0个月，固定时间生存有所获益。
结论：标准三联疗法带来了最大的生存获益；然而，GTR率近年来并未上升，接受标准治疗方面的重大差异持续存在。为实现更大的人群水平生存获益，扩大公平可及性并优先考虑最大程度的安全切除的努力至关重要。
查看英文原文 English abstract
Background: Population-level patterns in the real-world use of initial treatment combinations for glioblastoma remain poorly characterized. We evaluated national trends in treatment uptake over two decades and examined their associations with survival outcomes.
Methods: We assessed temporal trends (2000-2020) in treatment and survival among 46,186 patients with glioblastoma in the SEER registry. Logistic regression modeled treatment utilization, and Cox regression estimated survival.
Results: Among 46,186 patients (50.0% aged 40-65; 43.0% aged ≥65; 58.0% male), 43.5% underwent gross total resection (GTR), 32.0% subtotal resection, and 24.5% no surgery; 71.8% received radiotherapy and 61.3% received chemotherapy. From 2000 to 2020, utilization increased for any surgery (OR/year 1.03, 95% CI 1.028-1.036), radiotherapy (1.01, 1.010-1.017), and chemotherapy (1.08, 1.081-1.088), whereas the likelihood of GTR vs subtotal resection declined (0.92, 0.915-0.922). Triple therapy increased modestly (1.01, 1.005-1.012) but plateaued at 30%. Older age, non-lobar tumors, unmarried status, and lower income predicted lower odds of triple therapy; after adjustment, calendar year showed a marginal decline (aOR/year 0.99, 0.99-1.00). Median overall survival improved from 6.0 to 10.0 months, with gains in fixed-time survival.
Conclusion: Standard triple therapy conferred the greatest survival benefit; however, GTR rates did not rise in recent years, and substantial disparities in receipt of standard care persisted. Efforts to expand equitable access and prioritize maximal safe resection are essential to achieve greater population-level survival gains.
利益披露 Disclosure
J. Chen, None..
Q. Wu, None..
C. Boldig, None..
R. J. Macaulay, None..
A. Etame, None.