European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
Influence of treatment modalities on survival and progression free survival in primary spinal cord glioblastoma: a systematic review and individual participant data meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Guerra Pedro Lucas Negromonte, Silva Inaê Carolline Silveira, Lima Deoclides, Souza Mateus Rodrigues, Inoue Tomoo, Endo Toshiki, Carvalho Júnior Eduardo Vieira
Аннотация
INTRODUCTION: Glioblastoma (GBM) is the most common primary malignant tumor of the central nervous system, primarily affecting the brain. It infrequently occurs in the spinal cord, accounting for approximately 1.5% of all spinal cord tumors. Primary spinal cord GBM (sGBM) is associated with a poor prognosis, with a median overall survival (OS) of 12-15 months and a median progression-free survival (PFS) of 11.5 months. This study performed a systematic review and a individual participant data meta-analysis to evaluate the impact of various therapeutic strategies on OS and PFS in patients with sGBM.
METHODS: Following PRISMA guidelines, data from 278 patients extracted from 116 studies were analyzed. The literature search was conducted in August 2025 using the PubMed and Embase databases. Statistical analyses included Kaplan-Meier survival curves, the log-rank test, and univariate and multivariate Cox regression models.
RESULTS: The average age was 31 years, with a predominance of males (57.5%). Most patients underwent STR (63.6%) and received adjuvant treatment (84.6%). Mean OS was 16.1 months, while mean PFS was 11.6 months. Chemotherapy (CT) and Radiotherapy (RT) were associated with improved prognosis. Moreover, patients who underwent gross total resection (GTR) showed a lower risk of mortality compared with those who underwent Bx.
CONCLUSION: Chemotherapy, radiotherapy, and gross total resection demonstrated significant benefits for both OS and PFS. These findings underscore the relevance of adjuvant therapies and surgical extent in the management of primary spinal GBM. Future studies should address the impact of tumor genetic and molecular profiles on survival outcomes.
METHODS: Following PRISMA guidelines, data from 278 patients extracted from 116 studies were analyzed. The literature search was conducted in August 2025 using the PubMed and Embase databases. Statistical analyses included Kaplan-Meier survival curves, the log-rank test, and univariate and multivariate Cox regression models.
RESULTS: The average age was 31 years, with a predominance of males (57.5%). Most patients underwent STR (63.6%) and received adjuvant treatment (84.6%). Mean OS was 16.1 months, while mean PFS was 11.6 months. Chemotherapy (CT) and Radiotherapy (RT) were associated with improved prognosis. Moreover, patients who underwent gross total resection (GTR) showed a lower risk of mortality compared with those who underwent Bx.
CONCLUSION: Chemotherapy, radiotherapy, and gross total resection demonstrated significant benefits for both OS and PFS. These findings underscore the relevance of adjuvant therapies and surgical extent in the management of primary spinal GBM. Future studies should address the impact of tumor genetic and molecular profiles on survival outcomes.