59例骶尾部脊索瘤术后放疗后的生存分析  

Survival Analysis of 59 Patients with Sacral Chordomas Treated by Surgery and Radiotherapy

作　　者：路顺 邹炳文[2] 彭新皓 张菡奕 郎锦义 Lu Shun;Zou Bingwen;Peng Xinhao;Zhang Hanyi;Lang Jinyi(Sichuan Cancer Hospital & Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China;Department of Thoracic Cancer,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤医院.研究所四川省癌症防治中心电子科技大学医学院 [2]四川大学华西医院胸部肿瘤科,成都614041

出　　处：《肿瘤预防与治疗》2019年第1期38-42,共5页Journal of Cancer Control And Treatment

基　　金：四川省科技厅课题(编号:2017HH0096)~~

摘　　要：目的:明确骶尾部脊索瘤患者是否能从术后的辅助放疗中获益,并且探索恰当的术后放疗模式。方法:回顾性纳入59例无远处转移且病理诊断明确为骶尾部脊索瘤的患者,分析其术后辅助放疗的生存情况。患者分为3组:22例为单纯手术切除组,24例为手术联合术后图像引导下调强放疗(IG-IMRT)治疗组,13例为手术联合伽马刀(GKS)治疗组。结果:所有患者的5年生存率及5年无复发生存率分别为80.1%和44.5%;单纯手术组、IG-IMRT组及GKS组5年生存率分别为90.9%、87.5%及59.3%,5年无复发生存率分别为29.8%、70.9%和35.0%;术后辅助放疗组对比单纯手术组的5年无复发生存率差异具有统计学意义(P=0.029),IG-IMRT组的5年无复发生存率优于GKS组(P=0.023)。结论:术后辅助放疗有助于提升脊索瘤术后患者的5年无复发生存率,且术后辅助IG-IMRT可能是更为恰当的术后放疗模式。Objective:The aim of this study is to confirm whether patients with sacral chordoma benefit from adjuvant radiotherapy,and to determine the optimal photon radiotherapy module for patients with sacral chordomas after surgery.Methods:Fifty-nine patients pathologically diagnosed with non-metastatic sacral chordomas were recruited retrospectively for analysis.All patients received surgical resection after diagnosis.Among these patients,22 were treated by gross total resection only,while 24 were treated with IG-IMRT after operation,13 patients received GKS after operation.Results:The 5-year overall survival (OS)and recurrence-free survival (RFS)rates of all patients were 80.1% and 44.5%,respectively.For sacral ehordoma patients treated exclusively by surgery,the 5-year OS and 5-year RFS rates were 90.9% and 29.8%,respectively.In strati-fled analysis,the 5-year OS rates were 87.5% in the IG-IMRT group and 59.3% in the GKS group,respectively;the 5-year RFS rates were 70.9% and 35.0%,respectively.Patients with sacral chordomas treated with adjuvant radiotherapy had a better RFS than those treated by surgery only (P=0.029).Moreover,compared with the GKS group,the IG-IMRT group exhibited better RFS (P=0.023).Conclusion :We confirm that adjuvant radiotherapy improves.RFS but not OS in sacral chordoma patients after surgery,and favorable RFS is observed following IG-IMRT.These results suggest that IG-IM-RT is an appropriate module of adjuvant radiotherapy for sacral chordoma patients.

关 键 词：骶尾部脊索瘤 外科手术 辅助放疗 IG-IMRT GKS 

分 类 号：R739.93[医药卫生—肿瘤]