髓母细胞瘤复发相关因素分析及治疗方式探讨

Factors for the recurrence of medulloblastoma and related treatment strategies

目的探讨影响髓母细胞瘤复发时间的相关因素及治疗策略。方法回顾性分析中南大学湘雅医院神经外科2012年2月至2014年8月收治并取得完整随访资料的39例髓母细胞瘤患者的临床资料,包括一般情况、临床表现、治疗方式、复发时间及预后情况等。绘制生存曲线,并对相关因素进行单因素及多因素分析,探究其与无进展生存期的关系。结果 39例患者中,15例(38.5%)患者仅行开颅手术治疗,24例(61.5%)患者进行了术后放疗及化疗。随访患者总体无进展生存期中位数为16.0月;仅手术治疗组EFS中位数为6.0月;手术+放化疗组EFS中位数为21.0月。两组差异有统计学意义;而不同年龄、性别、肿瘤部位等因素对患者EFS的影响无明显统计学差异。结论以外科手术为基础,辅以术后放化疗的综合治疗相比于单纯手术能显著提高髓母细胞瘤术后无进展生存期。

Objective To investigate the factors for the recurrence of medulloblastoma and related treatment strategies. Methods A retrospective analysis was performed for the clinical data of 39 patients with medulloblastoma who were treated in Department of Neurosurgery, Xiangya Hospital of Central South University, from February 2012 to August 2014 and provided complete follow-up data, including general conditions, clinical manifestations, treatment methods, time to recurrence, and prognosis. The survival curve was plotted, and univariate and multivariate analyses were performed for related factors to analyze their association with progression-free survival. Results Of all 39 patients, 15 （38.5%） underwent craniotomy alone and 24 （61.5%） underwent surgery ＋ radiotherapy/chemotherapy. The median progression-free survival for all patients was 16.0 months. The median event-free survival （EFS） was 6.0 months in the surgical treatment group and 21.0 months in the surgery ＋ radiotherapy/chemotherapy group, and there was a significant differ- ence between the two groups. There was no significant difference in EFS between the patients with different ages, sexes, and tumor locations. Conclusions Surgical operation combined with postoperative radiochemotherapy can significantly improve the progression-free survival of patients with medulloblastoma, compared with surgery alone.