低级别星形细胞胶质瘤临床相关因素与生存分析

背景与目的：影响手术后低级别星形细胞胶质瘤预后的因素很多，对其治疗方式的选择仍有较多争议，判断预后的因素也不尽一致。本研究探讨低级别星形细胞瘤的临床相关因素与预后的关系，为脑胶质瘤的治疗选择提供理论依据。方法：应用Cox风险比例模型，行逐步回归分析研究2001年至2006年间确诊的123例低级别星形细胞瘤患者的性别、年龄、术前症状、KPS评分、发病至就诊时间、肿瘤部位、肿瘤大小、手术切除程度及术后放疗对生存时间的影响。结果：多因素分析示，术前有癫痫症状者生存时间较长（P〈0．05），术前有缺失症状（P=0.002）及发病至就诊时间短的患者（P=0．012）生存时间显著缩短。手术切除程度对生存时间无显著影响，对于术后放疗，共有51例患者（41．5％）行术后放疗，剂量在40～60Gy，无论单因素或多因素分析，其对生存时间均无显著影响（P=0．14）。结论：对于低级别星形细胞瘤，术前癫痫症状预示相对预后较好，手术切除程度及术后放疗对生存时间无明显影响。

Prognosis Factors in Low Grade Astrocytomas： Analysis of 123 Cases

BACKGROUND＆ OBJECTIVE： To investigate prognosis factors of patients with low-grade gliomas with the purpose to make treatment strategies for low-grade glioma patients. METHODS： Clinical data of 123 patients with low-grade gliomas admitted between 2001 and 2006 were retrospectively reviewed. The relationship between clinical factors including sex, age, preoperative symptoms, KPS score, the time to therapy, tumor location, tumor diameter, degree of tumor resection, postoperative radiotherapy and survival time were analyzed with Cox＇s regression mode RESULTS： In multivariate analysis, preoperative seizures （P〈0.05） was significantly correlated with longer survival time. Preoperative neurological deficits （P=0.002）and the shorter time to therapy （P=0.012）were the negatively affected prognosis, The difference of resection degree on prognosis was not statistically significant; The smvival time of patients received radiotherapy was not significantly different with that of patients without radiotherapy. CONCLUSIONS： Preoperative seizures seem to be associated with a better prognosis for low-grade glioma patients. Aggressive resection and post-operative radiation are not beneficial for low-grade glioma patients in our study.