规范治疗与脑胶质瘤患者的预后

目的探讨规范治疗对改善脑胶质瘤患者预后的重要意义。方法收集自2000年1月至2006年3月在我院治疗的有完整病案记录、随访资料和明确病理诊断的149例脑胶质瘤患者的资料。参照2005年美国National Comprehensive Cancer Network的诊疗规范，以及中山大学肿瘤防治中心脑胶质瘤单病种诊疗指引，将149例胶质瘤患者按照治疗情况分为规范治疗与不规范治疗两组，并对患者术后的生存状况及功能情况进行评估。结果低级别胶质瘤患者的中位生存时间规范治疗组为85个月和不规范治疗组为42个月，高级别胶质瘤患者规范治疗组为51个月，不规范治疗组为23个月，两组相较，均差异显著（P〈0．01）。低级别胶质瘤患者无疾病进展生存时间规范治疗组为66个月，不规范治疗组为33个月；高级别胶质瘤患者规范治疗组为32个月，不规范治疗组为13个月，两组相较，均差异显著（P〈0.01）。规范治疗组高、低级别胶质瘤患者的一年、两年及五年生存率均高于不规范治疗组（P〈0．05）。治疗后规范治疗组患者KPS功能评分显著高于不规范治疗组（P〈0．01）。结论规范治疗能明显改善脑胶质瘤患者预后，延长其生存时间，提高其生活质量，所以在神经肿瘤医生中强调对胶质瘤的规范治疗十分迫切。

Norm Treatment and Prognosis of Patients with Gliomas

Objective To explore the effect of norm treatment on prognosis in the patients with gliomas. Methods The clinical data, including the intact medical records, integrate following-up data and pathological data, of 149 patients with gliomas consulted or treated in the Cancer Center of Sun Yat-sen University from January, 2000 to March, 2006 were analysed retrospectively. The patients were divided into two groups, i.e. norm-treatment (NT) group(67 cases), where the patients were treated according to National comprehensive cancer network guideline (2005) as well as Sun Yat-sen University Cancer Center guideline, and improper treatment (IT) groups(82 cases), where the patients were not treated according to both the guidelines. The overall survival, progression-free survival (PFS), survival rate and the Karnofsky performance status(KPS) score were analyzed after the treatment in both the group. Results There was significant difference in the median survival time between the NT and IT groups in the patients with low-grade gliomas (85 to 42 months) and ones with high-grade gliomas (51 to 23 months) (P<0.01). The PFS time in the patients with low grade gliomas and ones with high grade of NT group was 66 months and 32 months respectively, and it in the patients with low grade gliomas and ones with high grade gliomas of IT group was 33 months and 13 months respectively. There was significant difference in the PFS time between the NT and IT groups (P<0.01). The 1-year, 2-year and 5-year survival rates of the patients with low and high-grade gliomas in NT group were significantly higher than those in IT group (P<0.05). KPS score was significantly higher in NT group than that in IT group (P<0.01). Conclusions The norm-treatment can improve the prognosis and life quality and prolong the survival time in patients with gliomas. The importance of norm-treatment of patients with gliomas should be emphasized.