Abstract：
OBJECTIVE: Neurocytomas represent 0.25 to 0.5% of primary brain tumours and are mainly found in young adults. These tumours have neuronal differentiation. The cornerstone treatment is neurosurgery. The efficacy of other therapies, including radiotherapy, is still unclear. The objective of this study was to evaluate the management of central neurocytomas and the role of radiotherapy.
METHODS: All adult patients (age 18 years or older) newly diagnosed with a histologically confirmed neurocytoma between 2006 and 2015 in France were included.
RESULTS: One hundred and sixteen patients were diagnosed with a central neurocytoma during the study period. All patients underwent surgical resection, and six received adjuvant radiotherapy. Eleven patients received radiotherapy due to progression. After a median follow-up of 68.7 months, local failure occurred in 29 patients. The 5-year local control rate was 73.4%. According to univariate analysis, marker of proliferation Ki67 index greater than 2% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.40-1.57; P=0.027) and subtotal resection (HR: 8.48; CI: 8.01-8.99; P<0.001) were associated with an increase in local failure. Gross total resection was associated with a higher risk of sequelae epilepsy (HR: 3.62; CI: 3.42-3.83; P<0.01) and memory disorders (HR: 1.35; CI: 1.07-1.20; P<0.01). Ten patients (8.6%) died during the follow-up. The 10-year overall survival rate was 89.0%. No prognostic factors for overall survival were found.
CONCLUSIONS: The analysis showed that patients who underwent subtotal surgical resection, particularly when the tumour had a Ki67 index greater than 2%, had an increased risk of local recurrence. These patients could benefit from adjuvant radiotherapy.
METHODS: All adult patients (age 18 years or older) newly diagnosed with a histologically confirmed neurocytoma between 2006 and 2015 in France were included.
RESULTS: One hundred and sixteen patients were diagnosed with a central neurocytoma during the study period. All patients underwent surgical resection, and six received adjuvant radiotherapy. Eleven patients received radiotherapy due to progression. After a median follow-up of 68.7 months, local failure occurred in 29 patients. The 5-year local control rate was 73.4%. According to univariate analysis, marker of proliferation Ki67 index greater than 2% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.40-1.57; P=0.027) and subtotal resection (HR: 8.48; CI: 8.01-8.99; P<0.001) were associated with an increase in local failure. Gross total resection was associated with a higher risk of sequelae epilepsy (HR: 3.62; CI: 3.42-3.83; P<0.01) and memory disorders (HR: 1.35; CI: 1.07-1.20; P<0.01). Ten patients (8.6%) died during the follow-up. The 10-year overall survival rate was 89.0%. No prognostic factors for overall survival were found.
CONCLUSIONS: The analysis showed that patients who underwent subtotal surgical resection, particularly when the tumour had a Ki67 index greater than 2%, had an increased risk of local recurrence. These patients could benefit from adjuvant radiotherapy.
摘要：
目的：神经细胞瘤占原发性脑肿瘤的0.25％至0.5％，主要见于年轻人。这些肿瘤具有神经元分化。基础治疗是神经外科。其他疗法的疗效，包括放射治疗,还不清楚。这项研究的目的是评估中枢神经细胞瘤的治疗和放射治疗的作用。
方法：纳入了法国2006年至2015年间新诊断为组织学确诊的神经细胞瘤的所有成年患者（18岁或以上）。
结果：研究期间有116例患者被诊断为中枢神经细胞瘤。所有患者均行手术切除,6人接受了辅助放疗。11例患者因病情进展接受放疗。在中位随访68.7个月后，29例患者发生局部衰竭。5年局部控制率为73.4%。根据单变量分析，增殖标志物Ki67指数大于2%(风险比[HR]:1.48;置信区间[CI]:1.40-1.57;P=0.027)和次全切除(HR:8.48;CI:8.01-8.99;P<0.001)与局部衰竭增加相关.总切除与癫痫后遗症（HR：3.62；CI：3.42-3.83；P<0.01）和记忆障碍（HR：1.35；CI：1.07-1.20；P<0.01）的风险较高。随访期间死亡10例(8.6%)。10年总生存率为89.0%。没有发现总生存期的预后因素。
结论：分析表明，接受手术次全切除的患者，特别是当肿瘤的Ki67指数大于2%时，局部复发的风险增加。这些患者可以从辅助放疗中获益。
方法：纳入了法国2006年至2015年间新诊断为组织学确诊的神经细胞瘤的所有成年患者（18岁或以上）。
结果：研究期间有116例患者被诊断为中枢神经细胞瘤。所有患者均行手术切除,6人接受了辅助放疗。11例患者因病情进展接受放疗。在中位随访68.7个月后，29例患者发生局部衰竭。5年局部控制率为73.4%。根据单变量分析，增殖标志物Ki67指数大于2%(风险比[HR]:1.48;置信区间[CI]:1.40-1.57;P=0.027)和次全切除(HR:8.48;CI:8.01-8.99;P<0.001)与局部衰竭增加相关.总切除与癫痫后遗症（HR：3.62；CI：3.42-3.83；P<0.01）和记忆障碍（HR：1.35；CI：1.07-1.20；P<0.01）的风险较高。随访期间死亡10例(8.6%)。10年总生存率为89.0%。没有发现总生存期的预后因素。
结论：分析表明，接受手术次全切除的患者，特别是当肿瘤的Ki67指数大于2%时，局部复发的风险增加。这些患者可以从辅助放疗中获益。
