磁共振引导^(125)I粒子植入挽救性治疗恶性脑胶质瘤1年预后相关因素分析  

Retrospective analysis of the results of glioma rescued the treatment with the implantation of magnetic resonance imaging-guided iodine-125 seeds and the exploration of the prognostic factors within one year

作　　者：郭宗通 柳明[1] 许玉军[1] 何祥萌[1] 李培培[1,3] 刘超 李成利[1] 

机构地区：[1]山东大学附属山东省医学影像学研究所MR介入研究室,山东济南250021 [2]肥城矿业中心医院影像科,山东泰安271600 [3]山东省聊城市肿瘤医院肿瘤科,山东聊城252000 [4]山东省泰安市中心医院肿瘤微创科,山东泰安271000

出　　处：《医学影像学杂志》2017年第9期1642-1645,共4页Journal of Medical Imaging

摘　　要：目的探讨磁共振引导^(125)I粒子植入挽救性治疗恶性脑胶质瘤1年预后相关因素分析。方法回顾性分析磁共振引导^(125)I粒子植入治疗的31例手术后放疗后复发、放疗后复发的恶性脑胶质瘤患者,其中Ⅲ级15例,IV级16例。选取性别、年龄、KPS评分、瘤体最长径、手术切除程度、病理分级、靶区剂量D90、肿瘤位置(小脑幕为界)8个因素,应用Kaplan-Meier进行生存分析,Cox比例风险回归模型进行预后的单因素和多因素分析。结果单因素分析显示年龄、KPS评分、手术切除程度、病理分级及靶区剂量D90是预后相关因素,组间差异均有统计学意义(P<0.05)。而性别、瘤体最长径、肿瘤位置组间差异无统计学意义(P>0.05)。Cox比例风险回归表明年龄≤50、KPS评分≥80分、手术切除完全、靶区剂量D90(90~100Gy)的患者^(125)I粒子植入治疗预后效果较好。结论年龄、KPS评分、手术切除程度、靶区剂量D90是影响^(125)I粒子植入治疗恶性脑胶质瘤的预后独立危险因素。Objective To analyze retrospectively the results of glioma treated with the implantation of iodine-125 seeds and to explore the prognostic factors within one year. Methods 31 evaluable glioma patients treated with the implantation of iodine-125 seed using a MR system with optical tracking navigation were studied retrospectively. Among them, 15 had Ⅲ-grade and 16 had Ⅳ-grade glioma. Gender, patient＇s age, Karnofsky scores, the longest diameter of the glioma, extent of resection, tumor histolo-gy, target dose D90, tumor location were factors influencing prognosis. Cumulative survival rates and influencing factors were ana-lyzed and compared using the life table method and Cox proportional hazard model. Results Univariate analysis showed that pa-tients with age≤50, Karnofsky scores≥80, extent of resection, tumor histology, target dose D90（90~100 Gy） before the im-plantation of iodine-125 seeds had better progonsis. The group discrepancies displayed statistical significance （ P 〈0. 05）. By contrast, gender, the longest diameter of the glioma, tumor location showed no statistical signifcance （ P 〉0. 05）. Conclusion Patients with age≤50, Karnofsky scores≥80, extent of resection, target dose D90（90~100 Gy） are factors for prognosis.

关 键 词：125I粒子 靶区剂量D90 磁共振成像 脑胶质瘤 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]