112例脑胶质瘤术后放射治疗的临床预后分析

Clinical prognostic analysis of 112 patients with glioma treated with postoperative radiotherapy

目的回顾性分析脑胶质瘤患者术后放射治疗的疗效,探讨评价影响放射治疗胶质瘤预后的因素。方法对临床资料完整的112例脑胶质瘤患者进行回顾性分析,其中Ⅰ～Ⅱ级胶质瘤54例,Ⅲ～Ⅳ级58例。手术全切61例,次全切43例,单纯活检8例。术后等待放射治疗的中位时间为27.5 d,放射治疗的中位剂量为56 Gy。采用Cox比例风险模型进行预后的单因素和多因素分析。结果低分级胶质瘤的1,3年生存率分别为88.9%和53.0%;高分级胶质瘤的1,3年生存率分别为68.9%和17.2%。年龄≤40岁、低分级胶质瘤、手术全切肿瘤、放疗前Karnofsky评分≥80分的患者预后较好。结论年龄、病理分级、手术切除程度以及放疗前的功能状况是影响胶质瘤放射治疗预后的独立因素。

Objective To analyze retrospectively the results of glioma treated with postoperative radiotherapy and to explore the prognostic factors. Methods 112 evaluable glioma patients were studied retrospectively. Of them, 54 had low-grade and 58 had high-grade gliomas. Sixty-one patients received grossly total resection and 43 subtotal resection, whereas 8 received biopsy only. External irradiation therapy started 27.5 clays after the surgery. Mean radiotherapy close was 56 Gy . Cumulative survival rate and influencing factors were analyzed and compared using the life table method and Cox proportional hazard model. Results The 1-and 3-year cumulative survival rates of patients with low-grade gliomas were 88. 9% and 53.0% respectively, as compared with 68.9% and 17. 2% in patients with high-grade gliomas. Univariate analysis showed that patients with age ≤40, low grade glioma, grossly total tumor resection and Karnofsky score ≥ 80 before radiotherapy had better prognosis. Conclusion Tumor histology, patient＇s age and extent of resection are factors influencing prognosis.