利用台灣健保資料庫做腦部惡性腫瘤之研究－－分析不同治療方式對高度分化神經膠質瘤之預後

Using the Taiwan National Health Insurance Research Database for Malignant Brain Tumor Research: Identifying the Optimal Treatment for High-Grade Glioma

主旨：目前對於高度分化神經膠質瘤病人的治療方式仍然還沒有定論。尤其是病人數相對稀少，單一研究中心很難收集到足夠的病人做研究。根據美國與歐洲的研究指出，疾病發生率為每年每十萬人大約2-3人。目前只有歐美有大型的研究比較不同的治療方式的癒後。在這個研究裡，利用台灣健保資料庫來分析高度分化神經膠質瘤病人接受不同治療方式之存活率。研究方法：我們利用2000-2009年健保資料庫來搜集高度分化神經膠質瘤病人。我們根據目前有提到的不同治療方式，將病人的治療方式分為八組。我們再利用Kaplan-Meier存活分析方法，比較各組病人的存活率。研究結果：從2000-2009年的健保資料庫裡，總共收集了121位高度分化神經膠質瘤病人。從存活分析中，病人有無使用抗癲癇藥物，對於病人的存活率沒有顯著差異，與歐美有相似的研究結論。結論：在我們的研究裡，病人有無使用抗癲癇藥物，對於病人的存活率沒有顯著差異。台灣健保資料庫可以得到與歐美癌症資料庫類似的研究結果，本研究證明台灣健保資料庫可以利用於分析對高度分化神經膠質瘤病人最佳的治療方式。 Purpose: Determining the optimal treatment protocols for high-grade glioma remains controversial. High-grade glioma patients are rare, with an incidence rate of approximately 2–3 in 100,000 per year in the United States and Europe. Currently only a few large studies have reported the efficacy of different treatment protocols. In this study, examined whether the Taiwan National Health Insurance Research Database (NHIRDB) can be used to study the efficacy of different treatments for high-grade glioma. Material and methods: Patients with high-grade glioma who underwent temozolomide (TMZ) were retrieved from the NHIRD from 2000 to 2009. We divided the patients into several subgroups according their treatment protocols. We used Kaplan–Meier survival analysis to compare survival in each group. Result: A total of 121 patients were retrieved from the NHIRD. Kaplan–Meier survival analysis revealed no significant differences between different treatment groups. Conclusion: In our study, the patients who received TMZ and radiotherapy with enzyme-inducing anti-epileptic drugs exhibited similar survival, which supports the findings of other European and Taiwanese studies. Based on our research, the NHIRDB can serve as a reliable resource for precision medicine research.

Purpose: Determining the optimal treatment protocols for high-grade glioma remains controversial. High-grade glioma patients are rare, with an incidence rate of approximately 2–3 in 100,000 per year in the United States and Europe. Currently only a few large studies have reported the efficacy of different treatment protocols. In this study, examined whether the Taiwan National Health Insurance Research Database (NHIRDB) can be used to study the efficacy of different treatments for high-grade glioma. Material and methods: Patients with high-grade glioma who underwent temozolomide (TMZ) were retrieved from the NHIRD from 2000 to 2009. We divided the patients into several subgroups according their treatment protocols. We used Kaplan–Meier survival analysis to compare survival in each group. Result: A total of 121 patients were retrieved from the NHIRD. Kaplan–Meier survival analysis revealed no significant differences between different treatment groups. Conclusion: In our study, the patients who received TMZ and radiotherapy with enzyme-inducing anti-epileptic drugs exhibited similar survival, which supports the findings of other European and Taiwanese studies. Based on our research, the NHIRDB can serve as a reliable resource for precision medicine research.