颅内多发高级别胶质瘤手术治疗及预后分析  

Surgical treatment of patients with intracranial multiple high grade glioma and its prognosis

作　　者：余鹏霄 马晓东[1] 张猛[1] 王强[1] 徐维林[1] 张宏伟[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《解放军医学院学报》2015年第7期699-701,723,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨手术和非手术两种治疗方式对颅内多发高级别胶质瘤的影响。方法回顾性分析2008年1月-2013年11月在本院神经外科治疗并经影像及术后病理证实为颅内多发高级别胶质瘤患者的临床特点、诊治经过及随访结果,比较手术切除肿瘤（手术组）与非手术切除（非手术组）对患者生存期的影响。手术组27例,其中男性15例,女性12例,年龄为8~67（44.4±13.6）岁,术前Karnofsky功能状态评分（Karnofsky performance status scale,KPS）为50~90（73.5±10.1）,WHOⅣ级胶质瘤21例,WHOⅢ级6例。非手术组10例,其中男性4例,女性6例,年龄为20~71（47.3±14.9）岁,KPS评分为50~90（75.5±11.3）,WHOⅣ级7例（70%）,WHOⅢ级3例。结果手术组中肿瘤全切率、次全切率及部分切除率分别为11.1%、18.5%、70.4%。手术组术后辅助放化疗者19例,未辅助放化疗者8例。非手术组行辅助放化疗者8例,未辅助放化疗者2例。随访1~24个月,手术组术后6个月、1年生存率分别为77.8%、32.1%,非手术组6个月、1年生存率分别为35.0%、11.7%。手术组中位生存期为10个月,非手术组中位生存期为5.5个月,手术组较非手术组生存期延长。结论对于颅内多发高级别胶质瘤的治疗,手术切除肿瘤较非手术治疗可延长患者生存期。Objective To explore the effects of operative and non-operative treatment for the intracranial high-grade multiple glioma. Methods Clinical characteristics, operative treatment and follow-up results in patients with high-grade multiple glioma that were confirmed by images and postoperative pathology from January 2008 to November 2013 in Chinese PLA General Hospital were retrospectively analyzed. Patients were divided into operative treatment group （n=27） and non-operative treatment group （n=10）. The survival of patients in operative and non-operative treatment were compared. In operative treatment group, there were 15 males and 12 females with a mean age of （44.4 ± 13.6） years （range, 8 - 67 years） and their mean KPS score were （73.5 ± 10.1） （range, 50 - 90）. Of the 27 cases, WHO IV was found in 21 cases and WHO Ⅲ in 6 cases. In non-operative treatment group, there were 4 males and 6 females with a mean age of （47.3 ± 14.9） years （range, 20 - 71 years） and their mean KPS score were （75.5 ± 11.3） （range, 50 - 90）. Of the 10 cases, WHO IV was found in 7 cases and WHO Ⅲ in 3 cases. Results The gross total resection, subtotal resection and partial resection rates were 11.1%, 18.5% and 70.4%, 19 cases were auxiliary to radiation or chemotherapy in operative treatment group, and 8 cases in non-operative treatment group. Patients were followed up for 1 - 24 months. The survival rate of 6-month, 1-year of operative treatment group and non-operative treatment group were 77.8%, 32.1% and 35.0%, 11.7%. The median survival time of operative treatment group was 10.0 months, which was longer than that of non-operative treatment group （5.5 months）. Conclusion Compared with non-operative treatment, surgical removal of the tumor can prolong the survival time in treatment of intracranial multiole high-grade glioma.

关 键 词：多发胶质瘤 高级别胶质瘤 手术治疗 

分 类 号：R739.41[医药卫生—肿瘤]