高级别脑干胶质瘤综合治疗结果及影响因素分析

Treatment Results and Prognostic Factors of High Grade Brainstem Glioma

目的 回顾性分析放射治疗的脑干肿瘤病例,探讨脑干肿瘤的预后及其影响因素.方法 选取2009年6月～2011年12月收治高级别脑干胶质瘤患者24例,随访患者总生存率,对相关指标进行单因素及多因素分析.结果 全组患者中位生存时间18.4个月,1、2、3年总生存率分别为62.5％、37.5％和26.8％.单因素及多因素分析显示WHO分级低和KPS评分高的患者预后较好.结论 WHO分级低和KPS评分高是高级别脑干胶质瘤患者独立的预后因素.

Objective A retrospective analysis was carried out to evaluate the prognosis and influence factors of brain stem tumors.Methods From Jun.2009 to Dec.2011,24 patients were eligible for the analysis.In all patients,9 cases accepted subtotal resection,22 cases received partial resection.13 cases accepted intensity-modulated radiation therapy （IMRT） and 11 cases accepted three dimensional radiotherapy （3 DCRT）,with 1.8-2.0Gy/f,total dose （DT） of 50.4 ～ 60.0Gy,the median DT of 54Gy.Seventeen cases accepted concurrent chemoradiotherapy of temozolomide.The significance of related prognostic factors was evaluated by univariate and multivariate analysis.Results In all patients,the median survival time was 18.4 months.The overall survival rate of 1,2 and 3 year was 62.5％,37.5％ and 26.8％,respectively.Univariate and multivariate analysis showed that lower WHO grade and higher Karnofsky score （KPS） gave a better survival.Conclusion WHO grade and KPS longer duration of symptoms and lesion confined to a single anatomic site are likely to be independent prognostic factors.