手术治疗脑胶质瘤预后的影响因素分析

Prognosis and influential factor analysis after glioma surgery

目的 研究脑胶质瘤术后疗效及影响因素。方法 5 7例脑胶质瘤患者中行全切4 1例 ,次全切 16例 ,术后均采用60 钴γ射线或电子直线加速器 6MV -X线放疗 ,2 9例同时予榄香烯治疗。结果 全切术后患者 1年生存率 5 6 % ,次全切术后患者 1年生存率 19%。低分级(星形细胞瘤 +间变性星形细胞瘤 ) 1年生存率 5 5 % ,高分级 (胶质母细胞瘤 +多形性胶质母细胞瘤 ) 1年生存率 8%。放疗前卡氏评分≤ 6 0分者 1年生存率为 17% ,卡氏评分≥ 70分 1年生存率为 6 5 %。结论 手术全切、病理低分级、放疗前卡氏评分≥ 70分的患者预后较好。手术切除程度、病理分级、放疗前卡氏评分是影响预后的重要因素。

Objective It is to study the curative effect after glioma surgery and influencing factor. Methods In 57 patients, 41 patients received grossly total resection and 16 patients received grossly subtotal resection. Postoperatively, all of them received radiotherapy of 60 Co γ-ray or linac 6MV-X-ray, moreover, 29 patients in them received chemotherapy of β-elemene. Results The one-year survival rate of patients received grossly total resection was 56%, while that of patients received grossly subtotal resection was 19%. The one-year survival rate of patients with low grade glioma (astrocytoma+ anaplasia astocytoma) was 55%, while that of patients with high grade glioma (colloid blastoma+polytypic colloid blastoma) was 8%. The one-year survival rate of patients with KPS less than 60 before radiotherapy was 17%, while that of patients with KPS more than 70 was 65%. Conclusion The patients with grossly total resection, low grade glioma, KPS more than 70 have better prognosis. Extent of resection, tumor histology and KPS before radiotherapy is main influential factors of prognosis.