脑胶质瘤术后放疗或同步放化疗78例临床分析

Effect of ostoperative radiotherapy or concurrent radiochemotherapy on 78 patients with intracranial glioma

目的 :对 78例脑胶质瘤术后接受单纯放疗或同步放化疗的患者进行回顾性生存分析。方法 :1 987年 1 1月～ 1 995年 5月间收治 78例脑胶质瘤患者 ,根据术后治疗方案不同分为两组。单纯放疗组 ,给予术后放疗 ,总剂量为 5 5Gy～ 60Gy;同步放化疗组 ,采用静脉给药或颈动脉插管给药。化疗与放疗同步进行。 结果 :单纯放疗组和同步放化疗组的中位生存期分别为 4 0个月和 3 6个月 ,两组无显著性差异 (P >0 .0 5 )。但是 ,从生存曲线上可以看出 ,当病理为Ⅰ、Ⅱ级时 ,单纯放疗组略好于同步放化疗组 ;病理为Ⅲ、Ⅳ级时 ,同步放化疗组略好于单纯放疗组。结论 :单纯放疗组的中位生存期与同步放化疗组之间无显著性差异。但通过分析各组的生存曲线 ,对病理为Ⅰ、Ⅱ级的脑胶质瘤患者 ,不提倡做术后化疗 ;病理为Ⅲ、Ⅳ级时 。

Objective:To retrospectively analyze the survival of 78 cases of intracranial gliomas received radiotherapy or concurrent radiochemotherapy postoperatively.Methods:Seventy eight cases of postoperative intracranial gliomas were treated in our hospital from Nov. 1987 to May 1995.They were divided into two groups according to their treatment methods,a group of radiotherapy (RT) and other group of concurrent radiochemotherapy (RCT). In th group of RT,routine postoperative external irradiation were administered with a total dose of 55 60Gy.In the group of RCT,patients received chemotherapy intravenously or by internal carotid artery infusion concurrently with radiotherapy.Results:The median survival times(MST)of groups of RT and RCT were 40 and 36 months,respectively.There was no significant difference between them ( P = 0.6237). But survival curves of each group showed the following tendency that when pathological diagnosis was gradeⅠor Ⅱ, the results of group of RT were better than that of group of RCT and when it was grade Ⅲ or Ⅳ, the results of group of RCT were better than that of group of RT.Conclusion:The median survival time of group of RT was not significantly different from that of group of RCT. But after further analysis to survival curves of each group,it is indicated that the treatment strategy of postoperative intracranial gliomas should be decided according to their pathological gradings.Patients with gradeⅠor Ⅱdo not seem to need chemotherapy, while patients with grade Ⅲ or Ⅳ,radiochemotherapy is necessary for prolonging survival time.