高级别脑胶质瘤综合治疗后生存分析

Survival analysis for high-grade glioma patients who received comprehensive treatment

目的:分析高级别脑胶质瘤患者综合治疗的疗效及影响预后的因素。方法:对湖南省肿瘤医院从2008年7月至2016年5月期间经术后病理证实为高级别脑胶质瘤(WHO III^IV级),且具有完整回访资料的64例患者进行回顾性分析。结果:随访3~111(中位数29.5)个月,中位总生存时间(median overall survival time,MOST)为36.00(95%CI:22.85~49.16)个月,中位无进展生存时间(median progression-free survival time,MPFS)为21.00(95%CI:9.72~32.28)个月,1,2,3,5年生存率分别为87.50%,56.25%,40.63%,17.19%。Log-Rank单因素分析、Cox回归模型分析均提示与高级别脑胶质瘤患者预后相关的因素有病理级别、切除程度、同步放化疗(P<0.05)。结论:高级别脑胶质瘤患者综合治疗后的总体生存时间、无进展生存时间及5年生存率有所提高,而与患者预后相关的因素有肿瘤病理级别、切除程度、同步放化疗,说明接受肿瘤全切及同步放化疗的WHO III级的胶质瘤患者的临床效果较好。

Objective： To analyze the curative effect and prognostic factors for comprehensive therapy in patients with high-grade glioma.Methods： Patients with high-grade glioma（WHO grade III, grade IV） were chosen from July2008 to May 2016 in the Hunan Cancer Hospital, and a retrospective analysis was performed in 64 patients with complete follow-up data. Results： The follow-up time was 3–111（median 29.5） months, the median overall survival time was 36.00（95% CI 22.85 to 49.16） months, the median progression-free survival time（PFS） was 21.00（95% CI 9.72 to 32.28） months. The 1-year, 2-year, 3-year and 5-year survival rates of highgrade glioma patients were 87.50%, 56.25%, 40.63% and 17.19%, respectively. The univariate analysis of Log-Rank test and the Cox regression model analysis showed that the prognostic factors related to the prognosis of high-grade glioma patients were pathological grade, resection degree, and concurrent chemo-radiotherapy（P〈0.05）. Conclusion： The overall survival time, progression-free survival time and the 5-year survival rate of patients with high-grade glioma after comprehensive treatment is partially improved. The factors relevant to the prognosis of patients with high-grade glioma are pathological grade, resection degree, and concurrent chemo-radiotherapy, indicating that the glioma patients（WHO grade III） received total resection of the tumor and concurrent chemo-radiotherapy have better clinical effect.