丙戊酸对134例放疗神经胶质瘤患者预后生存和肿瘤复发的影响

Effects of valproic acid on the survival and tumor recurrence of 134 patients with glioma treated with radiotherapy

目的通过丙戊酸(VPA)对放疗神经胶质瘤患者预后生存与肿瘤复发影响的分析,旨在从临床角度提供VPA增强放射对肿瘤生长的抑制和延长患者生存时间作用的研究依据。方法回顾性研究数据来自2012~2016年山东大学齐鲁医院肿瘤科接受手术和放疗的134例胶质瘤患者,收集患者的临床信息及随访记录,采用多因素Cox比例风险模型分析这些神经胶质瘤患者服用VPA对总生存期(OS)和无进展生存期(PFS)的影响。结果134例胶质瘤患者OS中位生存期为49个月,PFS中位生存期为52个月。单因素分析结果显示,VPA、病理分级、年龄和化疗与胶质瘤患者预后有关联(P<0.05);多因素分析在调整了年龄、病理分级和化疗的作用后,显示患者术后放疗并服用VPA可以改善胶质瘤患者的OS(HR=0.49,95%CI:0.30~0.80)和PFS(HR=0.56,95%CI:0.33~0.93)。结论VPA可以显著提高放疗神经胶质瘤患者生存时间,并且降低肿瘤的复发。

Objective To analyze the effects of valproic acid(VPA) on the prognostic survival and tumor recurrence of patients with glioma treated with radiotherapy, so as to provide a clinical basis for the study of the effect of VPA on enhancing the inhibition of tumor growth by radiation and prolonging the survival time of patients. Methods The clinical and follow-up data of 134 glioma patients who underwent surgery and radiotherapy in the Oncology Department of Qilu Hospital, Shandong University during 2012 and 2016 were retrospectively analyzed. The effects of VPA on overall survival(OS) and progression-free survival(PFS) were analyzed with multivariate Cox proportional hazard model. Results The median OS and PFS were 49 and 52 months, respectively. Univariate analysis showed VPA, pathological grade, age and chemotherapy were associated with the prognosis(P<0.05). Multivariate analysis showed, after adjustment of age, pathological grade and the effects of chemotherapy, VPA improved the OS(HR=0.49, 95%CI: 0.30-0.80) and PFS(HR=0.56, 95%CI: 0.33-0.93). Conclusion VPA can significantly prolong the survival time of patients with glioma and reduce tumor recurrence.