复发胶质瘤的预后评价及综合治疗效果分析  

Prognostic evaluations of recurrent gliomas and preliminary efficacies of combined modality therapy

作　　者：张新[1] 姚瑜[1] 秦智勇[1] 汪洋[1] 吴劲松[1] 毛颖[1] 周良辅[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《中华医学杂志》2013年第1期11-14,共4页National Medical Journal of China

基　　金：上海市科学技术委员会（10JC1402200）;上海市人才发展基金（2011063）;复旦大学“985工程”三期肿瘤研究项目Ⅱ（985III-YFX0102）;卫生部胶质瘤个体化治疗分子诊断技术临床应用研究（W2012FZ003）

摘　　要：目的初步评价并比较复发胶质瘤的预后及综合治疗效果。方法回顾性分析了2007年5月至2012年1月在华山医院神经外科接受治疗的62例复发胶质瘤，比较不同级别胶质瘤的预后及对综合治疗（手术，放疗，化疗及免疫治疗）的效果做出初步评价。结果复发胶质瘤的中位无进展期（TTP）6．0个月，中位生存期（Os）13．0个月；世界卫生组织（WHO）分级Ⅱ级（21例）、Ⅲ级（13例）、Ⅳ级（28例）胶质瘤复发后的中位TTP分别为9．0、9．0和5．0个月，平坶OS分别为26．6、21．4和13．8个月；化疗对复发胶质瘤的有效率为26．7％。结论化疗为主的综合治疗方案对部分复发胶质瘤的预后有一定程度改善。复发胶质瘤的预后与初发时的病理级别相关。Objective To evaluate the prognosis and efficacies of comprehensive treatment for recurrent gliomas. Methods A total of 62 patients diagnosed as recurrent gliomas at our hospital between May 2007 and January 2012 were reviewed and analyzed. The investigators compared the prognosis of different grades of gliomas and evaluated the efficacies of combined modality therapy of surgery, radiotherapy, chemotherapy and immunotherapy. Results Their median periods of time-to-progression （TIP） and overall survival （OS） were 6.0 and 13.0 months respectively. The median TIP of WHO gradeⅡ （ n = 21 ）, Ⅲ（ n = 13 ） and IV （ n = 28 ） recurrent gliomas were 9.0, 9.0 and 5.0 months respectively. And the average OS of WHO grade 11 , m and IV recurrent gliomas were 26.6, 21.4 and 13.8 months respectively. The efficacious rate of chemotherapy was 26： 7%. Conclusion Combined modality therapy based on chemotherapy may moderately improve the prognosis of recurrent gliomas. And the pathological grades of primary tumors are correlated with the prognosis of recurrent gliomas.

关 键 词：星形细胞瘤 复发 综合疗法 预后 

分 类 号：R739.4[医药卫生—肿瘤]