胶质母细胞瘤全切术后患者预后影响因素的前瞻性研究

Influences of partial correlation factors such as dietary, psychotherapy and hybaroxia etceteras in prognosis of patients suffered glioblastoma multiforme under total resection： a perspective study

目的分析影响胶质母细胞瘤全切术后患者预后的相关因素。方法选择北京天坛医院和北京天坛普华医院神经外科自2007年11月至2009年11月手术切除的胶质母细胞瘤患者39例，其中术后行单纯放化疗患者26例（对照组），术后除单纯放化疗外，添加热量限制饮食＋心理引导＋高压氧同步辅助化疗（CRPH）患者13例（实验组）。比较2组患者的生存曲线，分析胶质母细胞瘤患者临床资料与生存期的相关性。结果实验组患者的生存期[（36．6±12．6）月]比对照组[（19．1±11.3）月]长，实验组患者的累计生存率比对照组高，差异均有统计学意义（P〈0．05）。是否添加CRPH、手术次数与胶质母细胞瘤患者的生存期呈正相关关系（P〈0．05）；肿瘤体积、Ki-67、O6-甲基鸟嘌呤．DNA甲基转移酶（MGMT）、血管内皮生长因子（VEGF）表达强度与生存期呈负相关关系（P〈0．05）。结论CRPH可以明显延长胶质母细胞瘤患者的生存期。肿瘤体积、手术次数、MGMT、Ki-67、VEGF阳性率均与患者生存期相关。

Objective To research the influence of partial correlation factors in the prognosis of patients suffered glioblastoma multiforme （GBM） after total resection. Methods Thirty-nine patients, admitted to our hospitals from November 2007 to November 2009 and performed total resection, were chosen in our study; after the resections, 26 patients （control group） accepted radiotherapies and chemotherapies; 13 patients （experimental group） were furthermore treated by caloric restriction combined with psychotherapy and chemotherapy associated by hybaroxia （CRPH）. Survival curve of the two groups were compared; the correlations of clinical data of the GBM patients with survival time were analyzed. Results The survival time in the experimental group （[36.6 ±12.6] months） were significantly longer than that in the control group （[ 19.1 ±11.3] months, P〈0.05）; the cumulative survival rate in the experimental group was significantly higher than that in the control group （P〈0.05）. CRPH and resection times were significantly positively correlated with the prognosis of GBM （P=0.000 and 0.013）. Volume of tumor was negatively correlated with the prognosis of GBM significantly （P=0.013）. Ki-67, O6-methylguanine-DNA methyltransferase （MGMT） and vascular endothelial growth factor （VEGF） were significantly correlated with the prognosis ofGBM （P=-0.001, 0.022 and 0.001）. Conclusions CRPH can apparently prolong the life span of the patients suffered GBM. The volume of tumor, and MGMT, Ki-67 and VEGF levels are correlated to the prognosis of GBM.