Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8684974 | Journal of Clinical Neuroscience | 2018 | 6 Pages |
Abstract
Pleomorphic Xanthoastrocytoma [PXA] is a rare low grade glial tumor commonly affecting young adults. We did this systematic review and meta-analysis to identify prognostic factors and optimal treatment in these patients. A thorough search of the PubMed, Google scholar was made to find all possible publications related to grade II PXA. A total of 167 patients from 89 articles were included in the analysis. Median age of the entire cohort was 20â¯years. Headache was the most common presentation in 49.1% of the patients followed by seizure in 27.9%. Temporal lobe was the most common location of the tumor. 63% patents underwent a gross total resection [GTR] and 26.7% underwent a sub total excision [STR]. Adjuvant radiation was given to 17.6% of patients. Median follow-up for the entire cohort was 33â¯months. Estimated median overall survival [OS] for the entire cohort was 209.0â¯months [96% CI: 149.7-268.3]. Estimated median progression free survival [PFS] was 48â¯months [95% CI: 31.9-64.0]. In univariate and multivariate analysis younger patients and patients who underwent a GTR had a significantly better survival outcome. Use of adjuvant therapy was not found to be a significant factor affecting PFS or OS. Radiotherapy was used in salvage treatment in 76.1% of the patients. Younger patients and patients who undergo a GTR, have better survival outcomes. There is inadequate evidence to recommend routine adjuvant radiation or chemotherapy in all patients with grade II PXA.
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Authors
Supriya Mallick, Rony Benson, Wineeta Melgandi, Prashanth Giridhar, G.K. Rath,