高级别胶质瘤患者生存期的影响因素分析  

Analysis on multi-factor influencing survival time of high grade glioma in clinical treatment

作　　者：吴维宁 吴有志[1] 刘振[1] 林忠[1] 罗良生[1] 樊友武 吴鸣[1] WU Wei-ning;WU You-zhi;LIU Zhen(Department of Neurosurgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210001, China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)神经外科,南京210001

出　　处：《临床神经外科杂志》2020年第6期669-674,共6页Journal of Clinical Neurosurgery

摘　　要：目的探讨影响高级别胶质瘤(HGG)患者预后的主要因素。方法回顾性分析38例高级别胶质瘤患者的临床资料。患者均行不同程度的肿瘤显微手术切除、术后放疗和化疗等治疗。通过随访得到患者的总生存时间(OS)和肿瘤无进展生存时间(PFS)。对OS和PFS与相关临床因素进行单因素(Log rank检验)和多因素(COX回归)分析。结果肿瘤部分切除不能有效改善患者的OS,而近全切除和全切除均能明显延长患者的OS和PFS;近全切除与全切除患者OS、PFS的差异无统计学意义。同时术后同步行放疗和替莫唑胺化疗的治疗措施,比单独放疗能够有效延长患者的OS,但对PFS无明显改善。结论在允许的情况下应尽可能地多切除胶质瘤,但对于功能区的肿瘤,选择近全切除可以避免术后过多的神经功能损害,同时也延长患者生存时间。术后同步放化疗有助于改善术后患者的生存时间,值得推广。Objective To explore the main factors affecting the survive of patients with high-grade glioma(HGG).Methods The clinical data of 38 patients with HGG underwent different degrees of microsurgery resection,postoperative radiotherapy and chemotherapy,etc,were analyzed retrospectively.The overall survival(OS)of patients and progression-free survival(PFS)of tumors were collected by following up.The results were analyzed by Log rank test and COX regression.Results Partial resection of tumors could not improve patients'survival time,but subtotal resection and total resection could effectively prolong patients'OS and PFS.There was no statistical difference between subtotal resection and total resection of influence on patients'survival time.Meanwhile performing radiotherapy with temozolomide(TMZ)chemotherapy synchronously after surgery,compared with radiotherapy alone,could effectively prolong the patients OS,but not for PFS.Conclusions The glioma should be resected as much as possible if conditions permit.As for tumor locating in or adjacent functional areas,choosing subtotal resection can avoid postoperative neurologic damage,and prolong survival time,too.Postoperative radiation with chemotherapy synchronously is recommended to improve the survival of patients.

关 键 词：高级别胶质瘤 临床治疗 多因素 

分 类 号：R739.41[医药卫生—肿瘤] R651[医药卫生—临床医学]