血管肉瘤的临床分析  

Analysis of 41 patients with angiosarcomas

作　　者：高远红[1] 张玉晶[1] 钱图南[1] 刘新帆[1] 徐国镇[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院放射治疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2000年第4期248-251,共4页Chinese Journal of Radiation Oncology

摘　　要：目的　分析血管肉瘤治疗后的生存情况及影响预后的因素。方法　对中国医学科学院中国协和医科大学肿瘤医院收治的经病理证实的 41例血管肉瘤进行分析 ,其中综合治疗 (手术 +放射治疗 ;手术 +化疗 ;手术 +放射治疗 +化疗 ) 2 3例 ,非综合治疗 (手术 ;放射治疗 ) 18例。生存率用Kaplan Meier法计算 ,用Logrank法进行生存曲线比较 ,用Cox模型进行多因素回归分析。结果　出现复发或转移的中位时间为 10个月。局部复发 14例 ,占 38.9% ;远地转移 16例 ,占 44 .4% ,转移部位依次为淋巴结 8例、肺 8例、肝脏 5例、骨 4例、其它 4例。全组生存期 5个月至 2 4.5年 (中位 30个月 ) ,1、3、5、10年生存率分别为 6 7.5 %、46 .1%、34.5 %和 14.4%。综合治疗组 5年生存率为 42 .1% ,非综合治疗组为 10 .4% (χ2 =7.37,P =0 .0 0 7) ,其中手术 +放射治疗组 5年生存率为 6 4.5 % ,综合治疗组放射治疗剂量≥ 5 0Gy组 5年生存率为 6 6 .5 %。单因素分析显示肿瘤大小、恶性程度、治疗模式以及手术方式等与预后相关。多因素分析时肿瘤大小、恶性程度、治疗模式及手术方式等均为独立的预后因素。结论　血管肉瘤治疗方式以手术 +放射治疗为首选。影响预后的因素包括肿瘤大小、恶性程度。Objective To evaluate the survival, treatment and prognostic factors of 41 patients with angiosarcoma. Methods Forty one patients treated from November 1966 to June 1999 were analyzed. We calculated the survival rate with the Kaplan Meier method, compared the survival curves in Log rank test and analyzed the prognostic factors with Cox regression. Results The survival time varied from 5 months to 24.5 years, and the median survival time was 30 months. The 1 , 3 , 5 and 10 year actuarial survival rates were 67.5% , 46.1%, 34.5% and 14.4%, respectively. The 5 year survival rate was 42.1% for the combined therapy group compared with 10.4% of the single modality group(χ 2=7.37,P=0.007). The 5 year survival rate was 64.5% for surgery plus radiotherapy group with 66.5% for the subgroup with the radiation dose ≥50 Gy in the combined therapy group. Univariate analyses showed that the tumor size (P<0.05), malignant degree( P<0.01), mode of treatment (P<0.01) and surgical method (P<0.05) were significant factors and multivariate analyses showed they were independent prognostic factors. Conclusions Angiosarcoma ,having a poor prognosis is a high malignant tumor, with high rate of local recurrence and metastasis. Surgery plus radiotherapy is the treatment of choice for patients with angiosarcoma. The significant prognostic factors include the tumor size, malignant degree, mode of treatment and surgical method.

关 键 词：血管肉瘤 放射治疗 综合治疗 预后 

分 类 号：R732.2[医药卫生—肿瘤] R730.58[医药卫生—临床医学]