儿童髓母细胞瘤术后的生存情况及其影响因素分析

Postoperative survival of children with medulloblastoma and its influencing factor analysis

目的探讨儿童髓母细胞瘤(MB)术后的生存情况及其影响因素。方法回顾性分析2011年1月至2017年6月新疆医科大学第一附属医院神经外科采用手术治疗且临床资料完整的57例MB患儿的临床资料,术后接受放、化疗的患儿分别有26、21例(其中20例为放疗联合化疗)。随访患儿术后的生存情况等。绘制Kaplan-Meier生存曲线行生存分析,采用log-rank检验分析影响患儿总体生存期的可能因素。结果57例患儿的中位随访时间为27(6~64)个月。至随访末期,20例(35.1%)患儿存活;Kaplan-Meier生存分析显示,1、3、5年的生存率分别为71.4%,40.2%,22.2%;57例患儿的中位生存时间为27.3个月;术后行、未行放疗者的中位生存期分别为41.0、15.0个月,术后行、未行化疗者的中位生存期分别为42.5、15.0个月,差异均有统计学意义(均P<0.01);20例放疗联合化疗患儿的中位生存期为61.4个月,与27例单独行放疗或化疗患儿的40.7个月比较,差异有统计学意义(P=0.009);而不同性别、年龄、民族、肿瘤切除程度、肿瘤是否转移、病理学类型的患者间生存期的差异均无统计学意义(均P>0.05)。结论新疆地区MB患儿术后的生存期较短,术后放疗、化疗是影响其术后生存期的重要影响因素。

Objective To investigate the survival of children medulloblastoma(MB)after operation and its influencing factors.Methods A retrospective analysis was conducted on the clinical data of 57 children with MB who underwent surgical treatment and had complete clinical data at the Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University from January 2011 to June 2017.Among them,26 and 21 children underwent postoperative radiotherapy and chemotherapy respectively,and 20 out of them underwent radiotherapy+chemotherapy.The postoperative survival,radiotherapy and chemotherapy of the children were followed up.The Kaplan-Meier survival curve was drawn for survival analysis,and the log-rank test was used to analyze the possible factors affecting the overall survival of children.Results The median follow-up time of the 57 children was 27(6-64)months.At the end of follow-up,20 children(35.1%)survived,and the 1-,3-,and 5-year survival rates were 71.4%,40.2%,and 22.2%respectively.The Kaplan-Meier survival curve showed that the median survival time of 57 children was 27.3 months.The median survival time of patients with and without radiotherapy after surgery were 41.0 and 15.0 months respectively;the median survival time of children with radiotherapy and chemotherapy after surgery was 42.5 and 15.0 months respectively,and the differences were statistically significant(both P<0.01).The median survival time of 20 children with radiotherapy and chemotherapy was 61.4 months,which was significantly different compared with that of 27 children with radiotherapy or chemotherapy alone(40.7 months)(P=0.009).However,there were no significant differences in survival time among patients varying in the gender,age,ethnicity,degree of tumor resection,tumor metastasis,or pathological type(all P>0.05).Conclusion The postoperative survival time of children with MB in Xinjiang is short,and postoperative radiotherapy and chemotherapy are important factors affecting.