成人丘脑胶质瘤综合治疗的疗效分析  

Analysis of Curative Effect of Comprehensive Treatment of Adult Thalamic Glioma

作　　者：彭其斌[1] 赵建农[1] 王鹏程[1] 陈宝智[1] PENG Qi-bin;ZHAO Jian-nong;WANG Peng-cheng;CHEN Bao-zhi(Department of Neurosurgery,Renmin Hospital of Hainan,Hainan Haikou 570311,China)

机构地区：[1]海南省人民医院神经外科,海南海口570311

出　　处：《神经损伤与功能重建》2018年第12期622-625,共4页Neural Injury and Functional Reconstruction

摘　　要：目的:比较放疗期间同步化疗、单纯放疗及放疗后持续化疗对成人丘脑胶质瘤的疗效及不同因素对成人丘脑胶质瘤预后的影响。方法:选取丘脑胶质瘤成人患者33例,所有患者均接受肿瘤切除,手术后放疗期间同步化疗22例,单纯放疗11例,放疗后继续化疗20例(其中,放疗期间同步化疗后继续化疗15例,单纯放疗后继续化疗5例)。统计并比较不同组合治疗方案近期疗效,6个月、1年、2年生存率。结果:术后脑积水5例,行脑室-腹腔分流术。平均随访(18.62±5.32)个月,全组平均生存时间(17.40±6.71)个月;6个月、1年、2年总生存率分别为81.82%、69.70%和48.48%。单因素分析显示,丘脑胶质瘤患者总体生存率的影响因素包括WHO分级(P<0.05),病程长短(P<0.05),是否放疗期间同步化疗(P<0.05)。多因素分析显示病理WHO分级低、病程短、放疗期间同步化疗的丘脑胶质瘤患者预后较好(P<0.05)。结论:病理WHO分级、病程及是否放疗期间同步化疗是成人丘脑胶质瘤预后的主要影响因素,放疗期间同步化疗治疗成人丘脑胶质瘤疗效明显优于单纯放疗,而放疗后是否持续化疗未显示出明显差异。Objective:To compare the efficacy of continuous chemotherapy with simultaneous radiotherapy and radiotherapy alone and continuous chemotherapy after radiotherapy on adult thalamic glioma and the influence of different factors on the prognosis of adult thalamic glioma.Methods:For this study,33 adult patients diagnosed with thalamic glioma were selected.All patients underwent tumor resection;22 patients underwent synchronous chemotherapy during radiotherapy after surgery;11 patients underwent radiotherapy alone after surgery;20 patients were treated with continuous chemotherapy after radiotherapy(of these,15 patients underwent continuous chemotherapy after synchronous chemotherapy during radiotherapy and 5 patients underwent continuous chemotherapy after radiotherapy alone).The efficacy of different combinations of treatment regimens and the patient survival rate at 6 months,1 year,and 2 years were analyzed and compared.Results:After resection surgery,5 patients experienced postoperative hydrocephalus,and ventriculoperitoneal shunting was employed for treatment.The average follow-up time was(18.62±5.32)months.Of all patients,the median survival period was(17.40±6.71)months.The 6-month,1-,and 2-year overall survival rate was respectively 81.82%,69.70%,and 48.48%.Univariate analysis displayed that the factors that affect overall survival rate of patients with thalamic glioma include WHO grade(P<0.05),duration of disease(P<0.05),and synchronous radiotherapy(P<0.05).Multivariate analysis showed that patients with low WHO grade,short disease course,and concurrent chemoradiotherapy received better prognoses(P<0.05).Conclusion:Pathological WHO grade,course of disease,and synchronous chemotherapy during radiotherapy are the main factors affecting the prognosis of adult thalamic gliomas.Synchronous radiotherapy is superior to radiotherapy alone in the treatment of adult thalamic gliomas,and whether continuous chemotherapy is utlized after radiotherapy shows no significant difference.

关 键 词：丘脑胶质瘤 神经外科 放疗 替莫唑胺 预后 

分 类 号：R741[医药卫生—神经病学与精神病学] R651.1[医药卫生—临床医学]