儿童低级别胶质瘤术后放疗生存状态及生活质量分析

Survival analysis and quality of life of pediatric low grade glioma treated by postoperative radiotherapy

目的分析儿童低级别胶质瘤(LGG)患儿的临床特点,观察其术后放疗生存状态及生活质量。方法回顾性分析2011-2017年间我院放疗科收治的27例年龄≤14岁的儿童LGG患儿的临床资料。分析患儿5年总生存(OS)、无进展生存(PFS)率,并对存活患儿进行生活质量评估,包括体重指数(BMI)、日常生活活动能力及社会角色担当的评估。结果27例患儿5年OS、PFS率分别为92%、87%。25例目前仍存活患儿进行BMI测定,结果显示1例患儿轻度消瘦,3例超重,21例正常。日常生活活动能力测定方面,WeeFIM量表总得分>108分21例,<90分4例。社会角色担当的评估方面,5例延迟入学≥2年,2例因跛行存在困难外,其余适应状况良好;其中7例患儿成绩较差,但交流无障碍。结论儿童LGG术后放疗能取得较好的OS、PFS率;对于长期幸存患儿,少部分患儿可能出现生活质量下降,主要表现为运动功能和认知功能的下降。

Objective To analyze the clinical characteristics of children with low grade glioma(LGG)and evaluate their survival status and quality of life in LGG pediatric patients after postoperative radiotherapy.Methods Clinical data of 27 LGG children aged≤14 years admitted to Department of Radiation Oncology of our hospital from January 2011 to December 2017 were retrospectively analyzed.The 5-year overall survival(OS)and progression-free survival(PFS)were estimated with the Kaplan-Meier method.The quality of life was evaluated by body mass index(BMI),WeeFIM and enrollment situation.Results The 5-year OS and PFS of 27 pediatric patients were 92%and 87%.BMI was measured in 25 children who were still alive and the results showed that 1 child was slightly emaciated,3 were overweight and 21 were normal.The total score of WeeFIM was>108 in 21 cases and<90 in 4 cases.In terms of social role-playing assessment,5 cases delayed enrollment for≥2 years,2 cases had good adaptation except the difficulties due to lameness,7 of them had poor study performance,but had no communication barrier.Conclusions Children with LGG can obtain relatively excellent OS and PFS after postoperative radiotherapy.Part of the children with long-term survival may experience a declined quality of life,which is mainly manifested with a decline in motor and cognitive functions.