68例脑胶质瘤术后治疗及相关预后因素分析

Clinical multifactor analysis of prognosis for 68 postoperative patients with intracranial glioma

目的:探讨影响脑胶质瘤术后生存的相关因素。方法:回顾性分析68例脑胶质瘤术后患者的性别、年龄、族别、病理分级、肿瘤部位、瘤体大小及手术切除范围,根据术后治疗方案不同分为单纯放疗组和联合放化疗组,采用Kaplan-Miere绘制生存率曲线,用Log-rank检验和COX多因素回归分析法对治疗预后进行相关因素分析。结果:肿瘤的病理分级是影响生存率的预后相关因素(P=0.020),术后单纯放疗和联合放化疗组差异无统计学意义,但从生存曲线可以看出,联合放化疗组病理Ⅲ、Ⅳ级患者术后有好于单纯放疗组的趋势。结论:脑胶质瘤的预后与病理分级密切相关。病理Ⅰ、Ⅱ级患者不提倡行术后化疗,病理Ⅲ、Ⅳ级患者一般情况较好者术后可行放化疗。

Objective： To analyze the associated factors of surviving in postoperative patients with intracranial glioma. Methods： Sixty-eight cases of postoperative intracranial glioma were retrospectively joined this study. Including sex, age, nation, pathology, tumor spot, tumor size, resection range. They were divided into two groups according to their treatment methods, a group of radiotherapy （RT） and an other group of combineradiochemotherapy （RCT）. Kaplan-Miere survival curve and Cox regression model were applied to evaluate the overall survive rate and the prognostic factors respectively. Results： （1） The overall 1, 3 year survival rate were 80.4% and 36.8% respectively. （2） the grade of pathology was the main survival -related prognostic factors. There was no significant difference between RT and RCT. But survival curves of each group showed the following tendency that when pathological diagnosis was grade Ⅲ, Ⅳ the result of group of RCT were better than that of RT. Conclusions： The prognosis of intracranial glioma was closely associated with pathology grading. By the survival curves of each group, the treatment strategy should be selected according to their pathology grades. Patients with grade Ⅰ or Ⅱ do not seem to need chemotherapy while patients with grade Ⅲ or Ⅳ, radiochemotherapy is necessary for prolonging survival time.