恶性胶质瘤术后治疗疗效及预后因素分析  

Clinical Effect of Postoperative Radiotherapy and Prognostic Factors in 59 Patients with Malignant Glioma

作　　者：邹燕梅[1] 熊华[1] 于世英[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤中心,430030

出　　处：《实用癌症杂志》2009年第2期184-187,共4页The Practical Journal of Cancer

摘　　要：目的观察恶性胶质瘤术后治疗的疗效,并分析其预后影响因素。方法恶性胶质瘤59例,其中Ⅲ级24例,Ⅳ级35例,术后给予三维适形放疗,肿瘤剂量50～60 Gy/5～6周。13例患者行同步化疗,替莫唑胺75 mg/m2.d。按照WHO实体瘤疗效评价标准评估疗效。采用Kaplan-Meier法计算生存率,Cox模型进行多因素分析。结果近期有效率(CR+PR)为75.5%。全组病例1、3、5年生存率分别为52.5%(31/59)、27.1%(16/59)、10.1%(6/59)。单因素分析显示预后相关因素有年龄、病理分级、病变个数、手术切除程度、放疗前ECOG评分、手术至放疗开始的时间、同步化疗(P<0.05)。多因素分析显示手术切除程度、同步化疗是独立预后因素(P<0.05)。放疗期间23.7%的患者脑水肿加重。结论恶性胶质瘤术后放化疗疗效较好,手术切除程度和同步化疗是重要的预后影响因素。Objective To investigate the clinical effect of postoperative radiotherapy, and to analyze the prognostic factors in patients with malignant glioma. Methods 59 postoperative patients with grade IlI and IV cerebral glioma were treated with 3D conformal radiotherapy with a total dose of 50 -60Gy in 5 -6weeks. 13 patients also received concomitant chemotherapy with temozolomide in 75mg/m^2 · d. Clinical effect of postoperative radiotherapy was evaluated according to the WHO solid tumor effect assessment criterion. The overall survival was calculated by using Kaplan - Meier method, and multi - variates analysis was performed by using Cox regression model. Results The overall response rate was 75.5%. The 1 - ,3 - and 5 year overall survival rates were 52.5% （31/59） ,27.1% （16/59） and 10. l% （6/59） ,respectively. Age,pathological grade,number of tumors,resection extent,ECOG before radiotherapy, radiotherapy start time from surgery and concomitant chemoradiotherapy are the prognostic factors in univariate analysis （ P 〈 0.05 ）. But only resection extent and concomitant chemoradiotherapy were independent prognostic factors in multivariate analysis （ P 〈 0.05 ）. 23.7% patients had brain edema aggravation during the radiotherapy. Conclusion Postoperative radiotherapy could result in good clinical effect in malignant glioma. Resection extent and concomitant chemoradiotherapy are the independent prognostic factors.

关 键 词：恶性胶质瘤 放疗 化疗 预后 

分 类 号：R739.41[医药卫生—肿瘤]