AI Article Synopsis
- Pleomorphic Xanthoastrocytoma (PXA) is a rare low-grade brain tumor primarily affecting young adults, with symptoms like headaches and seizures being common.
- A review of 89 articles involving 167 patients showed that gross total resection (GTR) was performed in 63% of cases, leading to significantly better survival rates for younger patients and those who underwent GTR.
- Despite the use of adjuvant therapy in some cases, the study concluded that there isn't enough evidence to support standard adjuvant radiation or chemotherapy for all patients with grade II PXA.
Article 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 20 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 33 months. Estimated median overall survival [OS] for the entire cohort was 209.0 months [96% CI: 149.7-268.3]. Estimated median progression free survival [PFS] was 48 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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| http://dx.doi.org/10.1016/j.jocn.2018.05.003 | DOI Listing |
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