| 91例儿童髓母细胞瘤术后放射治疗的临床预后及相关因素分析 |
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| 引用本文： | 杨 慧,宋丽楠,倪文婕,刘骁蕾,侯栋梁.91例儿童髓母细胞瘤术后放射治疗的临床预后及相关因素分析[J].现代肿瘤医学,2023,0(5):839-842. |
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| 作者姓名： | 杨 慧 宋丽楠 倪文婕 刘骁蕾 侯栋梁 |
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| 作者单位： | 首都医科大学附属北京世纪坛医院放疗科，北京 100038 |
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| 摘 要： | 目的:探讨儿童髓母细胞瘤(medulloblastoma,MB)的术后放疗效果，分析影响其预后的相关因素。方法:回顾性分析2011年01月至2015年12月我院收治的91例儿童MB病历资料。对性别、年龄、肿瘤部位、手术切除程度、放疗前肿瘤M分期、危险度分组、放疗剂量、靶区范围、术后是否化疗、放疗与手术的时间间隔进行分析。采用Kaplan-Meier法进行生存分析，Log-rank检验进行单因素分析，采用Cox回归模型进行多因素分析。结果:本组患儿9例失访，失访率9.9%，其余82例随访满5年或死亡。随访期间，25例患儿出现局部复发或转移，经治疗后仍有16例死亡，9例带瘤生存，本组患儿3年、5年无进展生存率(progression-free survival，PFS)分别为79.3%、70.8%，3年、5年总生存率(overall survival，OS)分别为84.9%、81.3%。63例标危组的5年PFS和OS为77.5%、89.6%，其中11例行低剂量全中枢放疗的5年OS为76.2%。单因素分析显示，手术切除程度、放疗前肿瘤M分期、危险度分组对PFS(P=0.015，P=0.004，P=0.016)和OS(P=0.009，P=0.001，P=0.002)的影响，差异均有统计学意义。Cox多因素回归分析显示，放疗前肿瘤M分期是影响PFS(P=0.007)及OS(P=0.002)的独立危险因素。结论:手术切除程度、放疗前肿瘤M分期、危险度分组是儿童MB预后差的高危因素，放疗前肿瘤M分期是预后差的独立危险因素。在保证疗效的前提下，降低放疗剂量和靶区范围是研究的重点。
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| 关 键 词： | 儿童 髓母细胞瘤 放射治疗 预后影响因素 |
Clinical prognosis and related factors of 91 children with medulloblastoma after postoperative radiotherapy |
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| YANG Hui,SONG Linan,NI Wenjie,LIU Xiaolei,HOU Dongliang.Clinical prognosis and related factors of 91 children with medulloblastoma after postoperative radiotherapy[J].Journal of Modern Oncology,2023,0(5):839-842. |
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| Authors: | YANG Hui SONG Linan NI Wenjie LIU Xiaolei HOU Dongliang |
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| Affiliation: | Department of Radiotherapy,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China. |
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| Abstract: | Objective:To evaluate the clinical prognosis and related factors of children medulloblastoma(MB)after postoperative radiotherapy.Methods:91 children with MB treated in our hospital from January 2011 to December 2015 were analyzed retrospectively.Gender,age,tumor location,degree of surgical resection,M stage before radiotherapy,risk-grouping,dose of radiotherapy,radiotherapy target,postoperative chemotherapy or not,and radiotherapy-surgery interval were analyzed.Kaplan-Meier method was used for survival analysis,log rank test was used for univariate analysis,and Cox regression model was used for multivariate analysis.Results:In this group,9 patients were lost and the loss rate was 9.9%,the other 82 patients were followed up for 5 years or died.During the follow-up periods,25 patients had local recurrence or metastasis,of which 16 patients died after treatment,9 patients survived with tumor.The 3,5-year progression free survival(PFS) rates were 79.3%,70.8%and the 3,5-year overall survival(OS) rates were 84.9%,81.3% respectively.The 5-year PFS and OS of 63 patients in the average-risk group were 77.5% and 89.6%,of which 11 patients were treated with reduced-dose craniospinal irradiation,and the 5-year OS was 76.2%.On univariate analysis,the degree of surgical resection,M stage and risk-grouping affected PFS(P=0.015,P=0.004,P=0.016) and OS(P=0.009,P=0.001,P=0.002),with significantly differences.Cox regression multivariate analysis showed that M stage was an independent prognostic factor affecting PFS(P=0.007) and OS(P=0.002).Conclusion:The degree of surgical resection,M stage before radiotherapy and risk-grouping were high risk factors for poor prognosis in children with MB and M stage was an independent prognostic factor for poor prognosis.Reducing dose and volume of radiotherapy without compromising the prognosis is the focus in this field. |
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| Keywords: | children medulloblastoma radiotherapy prognostic inflence factor |
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