调强放疗序贯化疗治疗高级别脑胶质瘤疗效观察及影响因素分析  

Efficacy of intensity modulated radiotherapy with sequential chemotherapy in the treatment of high-grade glioma and analysis of influential factors

作　　者：吕建辉[1] 尹青梅[2] Lyu Jianhui;Yin Qingmei(Department of Tumor Radiotherapy,Yantai Municipal Laiyang Central Hospital,Yantai 265200,Shandong Province,China;Department of Anesthesiology,Yantai Municipal Laiyang Central Hospital,Yantai 265200,Shandong Province,China)

机构地区：[1]烟台市莱阳中心医院肿瘤放疗科,烟台265200 [2]烟台市莱阳中心医院麻醉科,烟台265200

出　　处：《中国基层医药》2023年第7期1045-1050,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的研究调强放疗序贯化疗治疗高级别脑胶质瘤的疗效以及影响患者预后的因素。方法回顾性分析烟台市莱阳中心医院2014年1月至2016年1月治疗的高级别脑胶质瘤患者56例,患者均采用三维适形放疗或增强放疗,对患者是否使用贝伐珠单抗、病理级别及术前术后卡氏(KPS)评分等资料进行记录。应用Cox等比例风险回归模型分析患者病死率的预测因素并进行受试者工作特征曲线(ROC曲线)分析。结果随访至2022年4月,结果显示,行替莫唑胺方案同步化疗和替莫唑胺辅助化疗患者的中位生存时间(OS)为11.6个月。单因素分析显示,患者病理级别、KPS评分、肿瘤切除程度与患者预后存在相关性(P=0.022、0.049、0.022)。多因素分析显示,肿瘤切除程度和病理级别是影响患者预后的独立影响因素(P=0.010、0.010)。生存曲线分析结果显示,肿瘤全切除患者的中位OS为12.6个月,肿瘤部分切除患者的中位OS为4.8个月,肿瘤全切除患者的OS长于肿瘤未全切除患者;世界卫生组织(WHO)神经系统肿瘤分级Ⅲ级患者的中位OS为25.2个月,Ⅳ级患者的中位OS为6.3个月,Ⅲ级患者的OS长于Ⅳ级患者,经过ROC曲线分析,WHO神经系统肿瘤分级、手术切除方式预测高级别脑胶质瘤患者死亡结果的曲线下面积分别为0.783、0.814,对患者预后预测均有较高的准确性。结论高级别脑胶质瘤患者低病理分级和全切除是患者预后独立保护因素。Objective To investigate the efficacy of intensity-modulated radiotherapy with sequential chemotherapy in the treatment of high-grade glioma and analyze the influential factors.Methods A total of 56 patients with high-grade glioma who received treatment in Yantai Municipal Laiyang Central Hospital from January 2014 to January 2016 were retrospectively analyzed.All patients underwent three-dimensional conformal radiotherapy or enhanced radiotherapy.The use of bevacizumab,pathological grade,and preoperative and postoperative Karnofsky Performance Status scores in all patients were recorded.Cox and other proportional risk regression models were used to analyze the predictors of patient mortality and receiver operating characteristic(ROC)curve analysis was performed.Results All patients were followed up to April 2022.Follow-up results showed that the median survival time of patients receiving concurrent chemotherapy with temozolomide and adjuvant chemotherapy with temozolomide was 11.6 months.Univariate analysis showed that pathological grade,Karnofsky Performance Status scores,and the degree of tumor resection were correlated with the prognosis of patients(P=0.022,0.049,0.022).Multivariate analysis showed that the degree of tumor resection and pathological grade were the independent influential factors of prognosis(P=0.010,0.010).Survival curve analysis revealed that the median survival time of patients subjected to total tumor resection was 12.6 months and that of patients subjected to partial tumor resection was 4.8 months.The median survival time of patients subjected to total tumor resection was longer than that of patients subjected to partial tumor resection.The median survival time of patients with WHO gradeⅢtumors was 25.2 months,and it was 6.3 months for patients with WHO gradeⅣtumors.The median survival time of patients with WHO gradeⅢtumors was longer than that of patients with WHO gradeⅣtumors.The receiver operating characteristic curve analysis results showed that the area under the receiver ope

关 键 词：脑桥神经胶质瘤 放射疗法 调强适形 药物疗法 联合 序贯 替莫唑胺 病理状态 体征和症状 比例危险度模型 手术类型 ROC曲线 

分 类 号：R739.41[医药卫生—肿瘤]