修订Tokuhashi评分与Rades评分在脊柱转移瘤预后预测中的应用比较  

Comparison of revised Tokuhashi scoring system and Rades score in predicting the prognosis of patients with spinal metastasis

作　　者：蒋欣廷[1] 张睿[1] 张玉容 童铃 彭国霖 程元辉[2] JIANG Xinting;ZHANG Rui;ZHANG Yurong;TONG Ling;PENG Guolin;CHENG Yuanhui(Department of Orthopedics,the First Peoples'Hospital of Yibin,Sichuan Yibin 644000,China;College of Clinical Medicine,Chongqing Medical and Pharmaceutical College,Chongqing 401331,China)

机构地区：[1]宜宾市第一人民医院骨科,四川宜宾644000 [2]重庆医药高等专科学校护理学院,重庆401331

出　　处：《现代肿瘤医学》2023年第24期4591-4596,共6页Journal of Modern Oncology

基　　金：四川省卫计委科研课题(编号:18PJ572)。

摘　　要：目的:比较修订Tokuhashi评分和Rades评分在脊柱转移瘤患者预后预测中的应用。方法:收集2010年01月至2020年12月我院骨科127例脊柱转移瘤住院患者的病历资料,随访结局至2022年06月30日,采用Kaplan-Meier法绘制生存曲线,Log-rankχ^(2)检验和Cox回归分析影响预后的因素,比较修订Tokuhashi评分和Rades评分在预测脊柱转移瘤患者预后的准确性。结果:患者生存时间为10(6,14)个月,随访期内死亡占比76.38%,6个月和12个月生存率分别为69.3%和27.6%。修订Tokuhashi评分0~8分、9~11分和≥12分的患者生存时间分别为(7.0±2.5)、(11.4±2.9)和(18.6±4.8)个月,Rades评分20~30分、31~35分及≥36分的患者生存时间分别为(7.0±2.6)、(11.7±2.3)和(17.7±4.7)个月。Cox回归显示:修订Tokuhashi评分系统中,修订Tokuhashi评分、受累椎体数量、脊柱外骨转移数量和是否存在内脏转移4个因素是患者预后的独立预测因子。Rades评分系统中,Rades评分、肿瘤诊断到脊柱转移时间和治疗前能否自由活动是患者预后的预测因子(P均<0.05)。修订Tokuhashi评分0~8分、9~11分和≥12分的患者6个月生存率分别为45.45%、91.18%和100.00%,Rades评分20~30分、31~35分和≥36分的患者6个月生存率分别为45.07%、100.00%和100.00%。结论:脊柱转移瘤患者预后差,修订Tokuhashi评分和Rades评分均能预测患者临床结局,尚无证据证明哪种评分系统更优越。Objective:To compare the application of revised Tokuhashi score and Rades score in predicting the prognosis of patients with spinal metastase.Method:From January 2010 to December 2020,127 hospitalized patients with spinal metastasis were selected from the orthopedic department of our hospital and follow-up until June 30,2022.The Kaplan-Meier method was used to draw the survival curve,and the Log-rank tests and Cox regression was used to analyze the influencing factors of prognosis.The accuracy and difference of the revised Tokuhashi score and Rades score were compared in predicting the prognosis of patients with spinal metastases.Results:The patient's survival time was 10(6,14)months,with a mortality rate of 76.38%during the follow-up period.The 6-month and 12-month survival rates were 69.3%and 27.6%,respectively.The survival time of patients with revised Tokuhashi scores of 0~8,9~11,and≥12 was(7.0±2.5),(11.4±2.9),and(18.6±4.8)months,respectively.The survival time of patients with Rades scores of 20~30,31~35,and≥36 was(7.0±2.6),(11.7±2.3),and(17.7±4.7)months,respectively.Cox regression showed that the revised Tokuhashi score,the number of affected vertebral bodies,the number of extraspinal bone metastases,and the presence or absence of visceral metastases are independent predictors of patient prognosis in the revised Tokuhashi scoring system.The Rades score,the time from tumor diagnosis to spinal metastasis and the ability to move freely before treatment are predictive factors for patient prognosis in the Rades scoring system(P<0.05).The 6-month survival rates of patients with revised Tokuhashi scores of 0~8,9~11,and≥12 were 45.45%,91.18%,and 100.00%,respectively.The 6-month survival rates of patients with Rades scores of 20~30,31~35,and≥36 were 45.07%,100.00%,and 100.00%,respectively.Conclusion:Patients with spinal metastases have poor prognosis,and both the revised Tokuhashi score and Rades score can predict clinical outcomes of patients.There is no evidence to prove which scoring system is superi

关 键 词：脊柱转移瘤 修订Tokuhashi评分 Rades评分 预后 

分 类 号：R738.1[医药卫生—肿瘤]