脑胶质瘤患者长期存活的临床因素分析

Analysis of the clinical factors related to long-term survival in glioma patients

目的 探讨胶质瘤患者长期生存相关的临床因素。方法 回顾性调查 1 980年 5月～ 1 995年 5月间在本院手术治疗的胶质瘤患者 ,对收集的资料整理量化 ,建立Logistic回归模型 (stepwise法 )进行分析。结果 长期生存的胶质瘤患者 1 0 2例 ,长期存活率占随访病例的 43.9% (1 0 2 / 2 32 )。病理级别、年龄、KPS、肿瘤部位、复发、复发后再手术、切除程度和手后放疗与胶质瘤患者的长期存活显著相关 ,其中复发后再手术、切除程度和手术后放疗是提高患者长期存活率的最重要因素。结论 应尽量在显微镜下行胶质瘤全切除 ,术后及时放疗和化疗 ;肿瘤复发时如KPS大于 70 ,特别是第一次手术病理级别低者 ,应予再手术治疗。

Objective Analysis of the clinical factors related to long term survival in glioma patients.Methods The glioma patients who received operation in our department from May 1980 to May 1995 were investigated,then the data were analyzed with Logistic regression analysis model (stepwise model).Results 102 cases (43.9%) survived for more than 5 years in those patients who were followed up.The following prognostic factors that were significantly correlated with long term survival were pathologic grade, age, KPS, glioma location, recurrence, reoperation, extent of resection and radiotherapy, and the last three factors were the most important factors. Conclusion Gliomas should be resected totoly undermicroscope and the patient should be treated with both radiotherapy and chemotherapy in time after operation .For recurrent glioma patients, it was necessary to receive reoperation if KPS were more than 70 and the pathology were low grade in first operation.