重症肌无力伴胸腺瘤患者术后放射治疗远期效果观察  

Long-term outcome of radiotherapy in patients of myasthenia gravis with thymoma

作　　者：吴涛[1] 涂来慧[1] 张仁琴[1] 金冶宁[2] 张晓松[2] 肖作平[2] 

机构地区：[1]第二军医大学长海医院神经科,上海200433 [2]长海医院放疗科

出　　处：《第二军医大学学报》2002年第4期430-432,共3页Academic Journal of Second Military Medical University

摘　　要：目的：研究伴胸腺瘤的重症肌无力（MG）患者术后放射治疗的效果。方法：观察和比较60例伴胸腺瘤MG患者术后放疗与43例术后未放疗患者的远期疗效和生存率。结果：术后放疗组的50例（83．3％）患者放疗后MG症状好转。随访1～15年，MG总有效率为78．3％，其中完全缓解者12例（20．0％）、药物缓解者16例（26．7％）；术后未放疗组MG总有效率为79．1％，其中完全缓解者16例（3．2％）、药物缓解者5例（11．6％），两组远期疗效差别无统计学意义（P＞0．05）。术后放疗组2、5和 10年生存率分别为 93．3％、80．0％和 467％，其中 Masaoka分期 Ⅰ－Ⅱ期者分别为 97．6％、92．8％和 83．3％，Ⅲ-Ⅳ期者分别为83．3％、50．0％和0％；术后未放疗组2年、5年和10年生存率分别为86．0％、74．4％和48．8％，其中Ⅰ-Ⅱ期者分别为94．7％、86．8％和71．l％，Ⅲ-Ⅳ期者分别为40．0％、0％和0％。两组Ⅲ-Ⅳ期患者生存率比较具有统计学意义（P＜0．01）。结论：放射治疗可以提高伴浸润性胸腺瘤的MG患者远期生存率和缓解MG症状。Objective: To evaluate the long-term outcome of radiotherapy in treatment of myasthenia gravis(MG) withthymoma. Methods: Sixty cases of MG with surgically proven thymoma were treated with radiotherapy and compared with 43cases without radiotherapy. The long-term outcome of MG and the survival rates were evaluated. Results: In 50 patients(83.3% ) symptoms of myasthenia gravis improved after radiotherapy. Follow-up data showed that overall effective rate ofmyasthenia gravis was 78.3 %, 12 patients had complete remission (20.0% ) and 16 had pharmacologic remission (26.7% ).In the non-radiotherapy group, overall effective rate was 79. 1 %, 16 patients had complete remission (37. 2% ) and 5 hadpharmacological remission (11.6 % ). There was on difference between these 2 groups (P>0. 05). The survival rates in theradiotherapy group were 93.3%, 80.0% and 46.7%, at 2, 5 and 10 years, respectively. The survival rates of Masaoka'sstage Ⅰ-Ⅱwere 97.6%, 92.8% and 83.3% respectively at 2, 5 and 10 years, and those of stage Ⅲ-Ⅳ were 83.3%, 50.0%and 0%. In the nonairadiotherapy group, the surviva1 rates were 86. 0%, 74. 4 % and 48. 8%, at 2, 5 and 10 years, respec-tively. The survival rates of Masaoka's stage Ⅰ- Ⅱwere 94. 7%, 86. 8% and 71. 1 % respectively at 2, 5 and 10 years, andthose of stage Ⅲ-Ⅳ were 40. 0%, 0% and 0%. Among patients stage Ⅲ-Ⅳ, survival was significantly higher for patientswith radiotherapy than for patients without radiotherapy (P<0. 0l). Conclusion: The administration of radiotherapy aftersurgery enhanced the long-term curative effects in the patients of MG with invasive thymoma.

关 键 词：术后放疗 术后未放疗 远期疗效 生存率 胸腺瘤 重症肌无力 放射疗法 合并症 对比分析 MG 

分 类 号：R746.1[医药卫生—神经病学与精神病学] R736.3[医药卫生—临床医学]