| 173例胶质瘤预后的影响因素分析 |
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| 引用本文： | 李剑峰,陈银生,赛,克,张湘衡,柯,超,杨群英,牟永告,许海雄,陈忠平.173例胶质瘤预后的影响因素分析[J].中国临床神经外科杂志,2016,0(6):327-330. |
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| 作者姓名： | 李剑峰 陈银生 赛 克 张湘衡 柯 超 杨群英 牟永告 许海雄 陈忠平 |
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| 作者单位： | 510060 广州，中山大学肿瘤防治中心神经外科（李剑峰、陈银生、赛 克、张湘衡、柯 超、杨群英、牟永告、陈忠平）；515031 广东汕头，中山大学附属汕头医院神经外科（李剑峰、许海雄） |
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| 摘 要： | 目的 探讨影响胶质瘤预后的相关因素。方法 对2000年1月至2009年12月在中山大学肿瘤防治中心首次手术病理确诊为胶质瘤的临床资料进行回顾性分析，并排除因非肿瘤因素死亡患者，采用Kaplan-Meier法进行生存率估计及Cox比例风险回归模型进行预后多因素分析。结果 本组纳入胶质瘤173例，其中WHO Ⅰ级10例，Ⅱ级61例，Ⅲ级53例，Ⅳ级49例；98例术后接受放疗高级别胶质瘤（WHOⅢ~Ⅳ级）61例，低级别胶质瘤（WHO Ⅰ~Ⅱ级）37例]；60例术后接受化疗（高级别胶质瘤46例，低级别胶质瘤14例）。本组患者1、3、5年总体生存率分别为74.0%、42.2%、32.4%；WHO Ⅰ、Ⅱ、Ⅲ、Ⅳ级的 5年生存率分别为80.0%、52.5%、24.5%、6.1%。分层分析显示术后辅助放化疗显著影响高级别胶质瘤生存率（P <0.05）。Cox比例风险回归模型分析结果 显示，年龄>40岁（RR=1.603；P=0.019）、WHO Ⅲ~Ⅳ分级（RR=2.311；P <0.001）、肿瘤未全切（RR=2.108；P <0.001）、术后未放疗（RR=1.652；P=0.008）是影响胶质瘤总体生存率的独立危险因素。结论 本组病例的分析结果 提示，发病年龄≤40岁、WHO级别低、肿瘤全切的胶质瘤患者预后好；术后进行放疗可以提高胶质瘤的疗效。
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| 关 键 词： | 胶质瘤 预后 影响因素 |
Prognostic factors for gliomas: analysis of 173 cases |
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| LI Jian-feng,,CHEN Yin-sheng,SAI Ke,ZHANG Xiang-heng,KE Chao,YANG Qun-ying,MOU Yong-gao,XU Hai-xiong,CHEN Zhong-ping..Prognostic factors for gliomas: analysis of 173 cases[J].Chinese Journal of Clinical Neurosurgery,2016,0(6):327-330. |
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| Authors: | LI Jian-feng CHEN Yin-sheng SAI Ke ZHANG Xiang-heng KE Chao YANG Qun-ying MOU Yong-gao XU Hai-xiong CHEN Zhong-ping |
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| Affiliation: | 1. Department of Neurosurgery, Cancer Medicine Center, Sun Yat-sen University, Guangzhou 515031, China; 2. Department of Neurosurgery, Affiliated Shantou Hospital of Sun Yat-Sen University, Shantou 515031, China |
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| Abstract: | Objective To analyze the prognostic factors for patietns with gliomas. Methods The clinical data of 173 patients with pathologically confirmed gliomas at Sun Yat-sen University Cancer Center from January of 2000 to December of 2009 were analyzed retrospectively. Survival was estimated by Kaplan-Meier analysis. The univariateand multivariate analysis of the factors related to the prognosis was performed. Results Among 173 patients, 10 (5.8%) were diagnosed with WHO grade Ⅰ gliomas, 61 (35.3%) with grade Ⅱgliomas, 53 (30.6%) with grade Ⅲ gliomas and 49 (28.3%) with glioblasto mamultiforme, respectively. Of 98 patients who received postoperative radiotherapy, 61 had high-grade gliomas (WHO grades Ⅲ and Ⅳ) and 37 low-grade gliomas (WHO grades Ⅰ and Ⅱ), respectively. Of 60 patients who received adjuvant chemotherapy, 46 had high-grade gliomas and 14 low-grade gliomas, respectively. The 1-, 3- and 5-year overall survival of 173 patients was 74.0%, 42.2% and 32.4%, respectively. The 5-year overall survival of the patients with gliomas of WHO grade Ⅰ, Ⅱ, Ⅲ and Ⅳ was 80.0%, 52.5%, 24.5% and 6.1%, respectively. The univariate analysis showed that gender, age, preoperative seizure, histological grade, tumor location (supratentorial or subtentorial) and extent of resection (total or partial) were factors related to the prognosis for patients with gliomas. The stratified analysis by log-rank test revealed that adjuvant radiotherapy was a prognostic factor for patients with high-grade gliomas but not for those with low-grade gliomas. Breslow test indicated that adjuvant chemotherapy was a prognostic factor for patients with high-grade gliomas. The multivariate analysis showed that the prognostic factors included age (≤40 or >40 years), histological grade, the extent of resection and post-operative radiotherapy for glioma patients. Conclusions The Results showed that the age ≤40 years, gliomas of lower grade and total resection of tumor were associated with improved overall survival in the patients with gliomas. The patients with high-grade gliomas and the patients with a certain subgroup of low-grade gliomas may benefit from post-operative radiotherapy and adjuvant chemotherapy. |
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| Keywords: | Glioma Treatment Prognosis Prognostic factor |
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