功能区低级别胶质瘤患者生存影响因素分析

Analysis of prognostic factors for survival in low-grade gliomas harboring eloquent areas

目的探讨功能区低级别胶质瘤(LGGs)患者生存影响因素。方法回顾性分析2011年1月至2015年6月安徽医科大学第一附属医院神经外科新诊断的62例功能区LGGs患者的临床资料,统计分析患者生存影响因素。结果单因素分析发现年龄<40岁、术前KPS≥70分、肿瘤全切、少突胶质细胞瘤、术后进行联合放化疗的功能区LGGs患者无进展生存期(PFS)和总生存期(OS)优于年龄≥40岁、术前KPS<70分、非全切、星形细胞瘤或混合性少突-星形细胞瘤、术后不放化疗或单独放疗/化疗患者,差异有统计学意义(P<0.05);多因素分析示年龄、术前KPS评分、手术切除程度、病理类型是影响生存的独立因素(P<0.05)。结论年龄较轻、术前高KPS评分及含有少突胶质细胞成分的功能区LGGs患者预后较佳,手术全切及术后放化疗能延长患者生存期。

Objective To investigate the prognostic factors for survival in patients who had low grade gliomas harboring brain elo-quent areas. Methods In this 5 years of study,62 cases newly diagnosed as low grade gliomas harboring eloquent areas were retro - analyzed to seek prognostic factors affecting survival. Firstly, Kaplan - meier method was applied to analyze 11 related clinical factors such as age,gen-der, initial symptom, histological subtype, and so on. Then Cox multivariate regression analysis was used. Results Univariate analysis showed that patients with age 〈40 years, preoperative KPS^70 points, total tumor resection, oligodendroglioma and postoperative chemo-therapy combined with radiotherapy had longer progression - free survival （ PFS） and overall survival （ OS） thanthose patients whose age ^40 years, preoperative KPS score of 〈 70 points, non - total cut, astrocytoma or mixed oligodendrocytomas, postoperative chemotherapy or ra-diotherapy alone, and the difference was statistically significant （P 〈0. 05）. Mutivariate analysis showed that age, preoperative KPS score, EOR, histological subtype were independent predictors in improving PFS and OS. Conclusion Patients with younger age, high preoperative KPS score,and low - grade gliomas with oligodendrocyte componets have better prognosis. Furthermore, surgical total resection and postopera-tive radio - chemotherapy could prolong the survival of patients.