星形细胞瘤

What is the survival rate for the different grades of astrocytoma?

• Grade 1, also called pilocytic, is usually cured with surgery. The five-year survival rate is around 96%.
• Grade 2, also called diffuse, astrocytomas have a median survival of about 7 to 8 years.
• Grade 3, also called anaplastic, astrocytomas have a median survival of about five years.
• Grade 4, also called glioblastoma, astrocytomas have a median survival of about 14 to 15 months.

How does IDH-mutant status change life expectancy?

• An IDH mutation is linked with longer survival and better response to therapy compared with IDH-wild-type tumors.
• For grade 2 disease, a change to the IDH1 gene is specifically linked with longer survival and has a better outlook than IDH wild type.

What is the prognosis for pilocytic astrocytoma in children?

Pilocytic astrocytoma (grade 1) in children is slow growing and often cured with surgery. The five-year survival rate is about 96%.

Anaplastic astrocytoma (grade 3): Factors linked to longer survival

Some people with anaplastic astrocytoma, also called grade 3, live much longer than the average five-year survival. In general, people with IDH-mutant tumors, who are younger, recover well from surgery, and receive both chemotherapy and radiation, are the most likely to have long-term survival.

Several factors can help improve outcomes:

• More complete tumor removal. When surgeons can safely remove most or all the tumor, people tend to live longer. The exact amount removed often makes a big difference.
• Combined treatment. Using surgery followed by both radiation and chemotherapy gives the best survival rates for high-grade tumors.
• Favorable tumor genetics. Tumors with certain gene changes, such as an IDH or MGMT gene change, tend to grow more slowly and respond better to treatment.
• Younger age and good overall health. Younger people and those with fewer neurological symptoms at diagnosis tend to do better.

Astrocytoma treatment is personalized. Surgery is usually first, followed by radiation or chemotherapy or both based on the tumor's grade and genes. Some people also may receive targeted therapy. Supportive care, also called palliative care, can start early to control symptoms and protect quality of life. New options, such as gene-targeted medicines and immunotherapy, are being tested in clinical trials and may expand choices over time.

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