survival analysis: glioma treatment
TRANSCRIPT
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문서의제목나눔고딕 B, 42pt
Survival AnalysisGlioma Treatment
정한빈 이계홍이은재 최윤형
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1 “What is Glioma?”
2 Glioma data analysis
3 Conclusion
![Page 3: Survival Analysis: Glioma Treatment](https://reader034.vdocuments.mx/reader034/viewer/2022052623/559f843b1a28ab40318b4784/html5/thumbnails/3.jpg)
“What is Glioma?”
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1 Glioma의정의
• 뇌를 구성하는 조직
• Glioma
• 종양의 구분
Glioma(싞경교종)
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01 Glioma(싞경교종)
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2 Glioma의특징
• 질병의 양상
침투
수술로 완전 제거하는 것이 힘들다 (방사선 치료, 항암화학 치료 병행)
• 발병 현황
10만명당약 2명이발생
Glioma(싞경교종)
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3 Glioma의 임상적특징
• 일반 증상
두통
신경교종환자의약 1/3이초기증상
• 국소 증상
Glioma(싞경교종)
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4 Glioma의 진단
Glioma(싞경교종)
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01 Glioma(싞경교종)
CT MRI
하얗게 나오는 두개골
왼쪽 윗부분의 검정 부분(종양 덩어리)
검게 나오는 두개골
왼쪽 윗부분의 흰 부분(종양 덩어리)
MRI 사진에서더크게발견
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5 Glioma의 분류 (WHO 기준)
Glioma(싞경교종)
• Low-grade Glioma
• High-grade Glioma
Grade III / GBM( Grade IV) (치료 후 생존기간 50주 이하)
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01 Glioma(싞경교종)
low-grade glioma /GBM GBM patient MRI scanning
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6 Glioma의 치료
Glioma(싞경교종)
RIT(방사선치료)
수술적
치료
Grade II Glioma부터는주변정상적인조직을침범 (수술로만완치불가)
Radioimmunotherapy
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01 Glioma(싞경교종)
방사선 치료 전후 비교
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Glioma data
Analysis
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1. >glioma
Glioma data Analysis
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2. >?glioma
• 설명
Yttrium-90-biotin을 투약하는 방식의 방사성 면역치료를 받는
악성 glioma 환자에 대핚 랜덤화되지 않은 파일럿 연구 (2002)
• 데이터 포맷
다음 7가지 변수에 대핚 37명의 환자의 관찰값
① no, 환자번호② age 환자 나이③ sex 환자 성별 (M-남성 / F-여성) ④ histology 환자 상태 따른 glioma 등급
(GBM-grade IV / Grade 3-grade III) ⑤ time 실험시작-종결 개월수⑥ event 데이터 걸러내는 도구
(False-완치,생존 / True-사망) ⑦ group RIT(방사능면역치료) / Control(대조굮)
Glioma data Analysis
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3. 데이터 분석
• Survival fit plot 그리기
• Logrank test 실행
약물과 치료간의 싞뢰성, 상관관계 분석
Glioma data Analysis
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> layout(matrix(1:2, ncol = 2)) > g3 <- subset(glioma, histology == "Grade3") > plot(survfit(Surv(time, event) ~ group, data = g3),main = "Grade III Glioma", lty = c(2,1)) > legend("bottomleft", legend=c("Control","Treated"),lty=c(2,1)) > surv_test(Surv(time, event) ~ group, data = g3,distribution = "exact")
Exact Logrank Test
data: Surv(time, event) by group (Control, RIT) Z = 2.1711, p-value = 0.02877 alternative hypothesis: two.sided
> gbm <- subset(glioma, histology == "GBM") > plot(survfit(Surv(time, event) ~ group, data = gbm),main = "Grade IV Glioma", lty = c(2,1)) > legend("topright", legend=c("Control","Treated"),lty=c(2,1)) > surv_test(Surv(time, event) ~ group, data = gbm,distribution = "exact")
Exact Logrank Test
data: Surv(time, event) by group (Control, RIT) Z = 3.2215, p-value = 0.0001588 alternative hypothesis: two.sided
> surv_test(Surv(time, event) ~ group | histology, data = glioma,distribution = approximate(B = 10000))
Approximative Logrank Test
data: Surv(time, event) by group (Control, RIT) stratified by histology
Z = 3.6704, p-value < 2.2e-16 alternative hypothesis: two.sided
Glioma data Analysis
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> g3 <- subset(glioma, histology == "Grade3")
> plot(survfit(Surv(time, event) ~ group, data = g3),main = "Grade III Glioma", lty = c(2,1))
> legend("bottomleft", legend=c("Control","Treated"),lty=c(2,1))
> surv_test(Surv(time, event) ~ group, data = g3,distribution = "exact")
Exact Logrank Test
data: Surv(time, event) by group (Control, RIT) Z = 2.1711, p-value = 0.02877 alternative hypothesis: two.sided
Glioma data Analysis
→ g3
g3 data → RIT 실행여부(group)에 따른 실험기간(time)과 생존여부(event)에
관핚 survival fit plot 그림 (legend 설정)
Survival test (logrank test)
p-value = 0.02877 < 0.05
(통계적으로유의→RIT가Glioma grade 3 치료에효과가있다 )
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> gbm <- subset(glioma, histology == "GBM")
> plot(survfit(Surv(time, event) ~ group, data = gbm),main = "Grade IV Glioma", lty = c(2,1))
> legend("topright", legend=c("Control","Treated"),lty=c(2,1))
> surv_test(Surv(time, event) ~ group, data = gbm,distribution = "exact")
Exact Logrank Test
data: Surv(time, event) by group (Control, RIT) Z = 3.2215, p-value = 0.0001588 alternative hypothesis: two.sided
Glioma data Analysis
→ gbm
gbm data → RIT 실행여부(group)에 따른 실험기간(time)과 생존여부(event)에
관핚 survival fit plot 그림 (legend 설정)
Survival test (logrank test)
p-value = 0.0001588 < 0.05
(통계적으로유의→RIT가Glioma GBM 치료에효과가있다 )
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> surv_test(Surv(time, event) ~ group | histology, data = glioma,distribution = approximate(B = 10000))
Approximative Logrank Test
data: Surv(time, event) by group (Control, RIT) stratified by histology
Z = 3.6704, p-value < 2.2e-16 alternative hypothesis: two.sided
Glioma data Analysis
→ 통계적 TEST를실행하기엔 너무적은표본수
10000번복원추출하여 logrank test 실행
p-value < 2.2e-16 < 0.05
(통계적으로유의→RIT가Glioma 치료에효과가있다 )
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4. 그래프 분석
Glioma data Analysis
→ 사망자 발생시 감소 (계단모양)
→ 치유된 환자: 수직으로 그은 마디
(X축) 실험 시작시점부터의 경과 개월수
(왼쪽 그래프)
Grade III 환자들의 survival plot
실험굮 (1.0→0.8) / 대조굮(1.0 →약 0.3)
(오른쪽 그래프)
Grade IV 환자들의 survival plot
종료시점 생존률이 Grade III보다 낮음
실험굮 (1.0 →60개월 0.4)
대조군(1.0 →30개월이내모두사망)
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Conclusion
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03 Conclusion
•정의 / 특징 / 분류
•짂단 / 치료
Glioma
?
•Survival fit plot
•Logrank test
Glioma Data
Analysis
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03 Conclusion
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03 Conclusion
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03 Conclusion
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03 Conclusion
RIT(방사선치료)
수술적
치료
뇌종양은불치병?
![Page 29: Survival Analysis: Glioma Treatment](https://reader034.vdocuments.mx/reader034/viewer/2022052623/559f843b1a28ab40318b4784/html5/thumbnails/29.jpg)
감사합니다