影响脑干胶质瘤的预后因素分析

Analysis of prognostic factors affecting brainstem glioma

目的通过脑干胶质瘤(brainstem gliomas,BSG)调强放疗单中心回顾性分析研究,探讨脑干胶质瘤调强放疗后的总生存(OS)及影响预后的因素。方法收集北京大学肿瘤医院放疗科2012年1月至2019年9月接受调强放疗资料完整的脑干胶质瘤病例,回顾性分析患者的总生存及影响因素,预后因素分析包括:性别、年龄、手术方式、影像学分型、发病部位、世界卫生组织(WHO)分级、是否化疗、放疗方式、症状至首次治疗时间、放疗剂量。结果共收集21例患者,随访时间≥3个月的脑干胶质瘤患者有18例,中位随访时间15.5(5.3~25.6)个月,中位生存时间(mOS)20(14.1~25.8)个月,1年和2年总生存率分别为86.2%和34.5%。影响脑干胶质瘤患者放疗疗效的因素包括手术方式、影像学分型、发病部位、WHO分级、放疗方式(χ2=4.829~20.261,P<0.05)。结论肿瘤大部分及以上手术切除、局灶内生型/外生型、发病部位在中脑、低级别肿瘤、肿瘤切除术后放疗的患者预后较好,对指导临床具有一定参考价值。

Objective To explore overall survival(OS)and prognostic factors of brainstem gliomas(BSG)after intensity modulated radiotherapy(IMRT)by a retrospective single-center analysis.Methods A total of twenty-one patients with BSG were collected in the Department of Radiation Oncology,Peking University Cancer Hospital from January 2012 to September 2019.All patients underwent IMRT.OS and potential prognostic factors were analyzed,including gender,age,operation type,imaging classification,tumor location,WHO grade,chemotherapy,radiotherapy pattern,time interval between morbidity and the first treatment,and radiation dose.Results Eighteen of twenty-one patients were followed up more than 3 months.The median follow-up time was 15.5(5.3-25.6)months.The median overall survival(mOS)was 20(14.1-25.8)months.The 1 and 2-year OS rates were 86.2%and 34.5%respectively.Operation type,imaging classification,tumor location,WHO grade and radiotherapy pattern were the prognosis factors(χ2=4.829-20.261,P<0.05).Conclusions Patients with maximal safe surgical resection,focal endogenesis/exogenesis,tumor located in mesencephalon,low-grade gliomas and/or received postoperative radiotherapy have a better prognosis.It has certain reference value for guiding the clinical practice.