高、低剂量放射治疗对低级别脑胶质瘤患者术后健康影响的跟踪研究

目的探讨不同剂量的放射治疗对低级别胶质瘤术后患者生存质量产生的影响，为低级别胶质瘤患者的治疗决策提供有利依据。 方法选取陆军军医大学第三附属医院神经外科自2012年1月至2016年1月收治的低级别胶质瘤患者132例，进行完全随机化分组治疗，分为高剂量放射治疗组41例、低剂量放射治疗组32例和观察组（未进行放射治疗）59例。3组患者均未进行化学治疗药物的干预。对3组患者进行为期1年的随访，采用健康生活简表（SF-36）、焦虑自评量表（SAS）和抑郁自评量表(SDS)评估术前1周内、术后1个月、3个月、6个月及1年的健康质量和心理状态。 结果SF-36量表结果显示，高剂量放射治疗组术后的生理机能、躯体疼痛、精力和社会功能方面低于低剂量放射治疗组和观察组，差异具有统计学意义（P<0.05），在生理职能、总体健康状态、情感职能和精神健康方面，3组间差异无统计学意义（P>0.05）。SAS、SDS量表评分显示高剂量放射治疗组和低剂量放射治疗组患者比观察组有明显焦虑、抑郁倾向，差异具有统计学意义（P<0.05）。 结论低级别脑胶质瘤术后行高剂量放射治疗对患者短期生存质量有一定影响，且恢复期长。建议对低级别胶质瘤术后的患者进行低剂量的放射治疗。而且对于年纪较轻且预后良好的患者，建议术后观察随访，避免生活存量的下降和射线造成的潜在影响。

Follow up study on the quality of life and emotion in patients with low-grade gliomas through high or low dose radiotherapy after postoperative

ObjectiveTo investigate the quality of life and psychological condition of patients with low-grade glioma undergoing surgery combined radiotherapy by the MOS item short from health survey (SF-36), anxiety scale (SAS) and self-rating depression scale (SDS) to assessment of patients with physical, psychological, mental, emotional state, etc. Investigate the effect of different doses of radiotherapy on the quality of life of patients with low-grade gliomas after operation, and to provide a favorable basis for the treatment of patients with low-grade glioma. MethodsA total of 132 patients with low-grade glioma were recruited in the Department of Neurosurgery, Third Affiliated Hospital of Army Medical University from January 2012 to January 2016. All patients were randomized into three groups: 41 patients in the high dose radiotherapy group, 32 patients in the low dose radiotherapy group and 59 patients in the observation group (without radiotherapy, chemotherapy and other drugs after surgical resection of the tumor). Three groups of patients were followed up for 1 year, the quality of life and psychological assessed by SF-36, SAS and SDS were collected and statistical analyses. ResultsThe results of SF-36 scale showed that the physiological function, physical pain, energy and social function of the high-dose radiation group were lower than those of the low-dose radiation group and the observation group (P<0.05). There was no significant difference among the three groups in physiological function, general health status, emotional function and mental health (P>0.05). The scores of SAS and SDS showed that the patients in the high dose radiation group and the low dose radiation group had more anxiety and depression tendency than those in the observation group, and the difference was statistically significant (P<0.05). ConclusionHigh-dose radiotherapy after low-grade glioma surgery has a certain impact on short-term quality of life of patients, and the recovery period is long. It is suggested that low-dose radiotherapy be given to patients with low-grade glioma after surgery. For younger patients with good prognosis, it is suggested that follow-up be observed after surgery to avoid the decline of life stock and the potential impact of radiation.