恶性脑胶质瘤预后相关多因素分析

Multivariate analysis on the prognosis correlation factors of patients with malignant gliomas

目的了解恶性脑胶质瘤的治疗现状，分析不同治疗方法对患者生存期的影响，研究影响恶性脑胶质瘤预后的相关因素，为规范化、个体化治疗恶性脑胶质瘤提供指导。方法依据治疗方式不同，对我院自2001年1月至2010年1月经术后病理证实为恶性脑胶质瘤，且随访成功的68例患者进行回顾性分析。结果全组病例1、2、5年生存率分别为54．2％、41．9％、16．2％。平均生存时间（29．4±5．18）个月。Cox模型多因素分析显示影响预后的独立因素有：年龄、肿瘤级别、肿瘤切除程度（P〈0．05）；Log—rank检验单因素分析发现与预后相关的因素有：年龄、肿瘤级别、治疗方式（P〈0．05）。结论恶性胶质瘤的预后较差，特别是Ⅳ级的胶质母细胞瘤。术后采取以手术、放化疗为主的综合治疗可以延长患者生存时间，改善预后。

Objective To study on the status of malignant gliomas, analyze the effect of different therapies, and find out the relevant factors to their different prognosis. Methods The clinical data of 68 patients from January 2001 to January 2010 with malignant glioma, treated in our department in recent 10 years, were analyzed retrospectively. Result The overall survival rate of 1, 2, and 5 year were 54. 2%, 41.9% , and 16. 2%, respectively. The postoperative survival time in whole cases was （ 29.4 ± 5.18 ） months. The Cox regression model showed that age, pathological grade of tumor and resection extent were independent prognostic factors （ P 〈 0. 05 ） , and age, pathological grade of tumor and therapy were the prognostic factors in univariate analysis （ P 〈 0.05 ）. Conclusion The prognosis of patients with malignant glioma is still poor, especially in glioblastoma （WHO grade IV ）. The integrative treatment strategies of surgery concomitant with ehemoradiotherapy could prolong the postoperative survival time, and improve the prognosis of patients.