论文部分内容阅读
目的:回顾性分析高分级脑胶质瘤(high grade glioma,HGG)术后精确放疗预后及其影响因素。方法:回顾性分析山西省肿瘤医院放射治疗中心2007-09-2012-03收治的HGG术后患者66例,均行手术治疗,其中肉眼全切36例,次全切除术30例。术后25例行三维适形放疗(three-dimensional conformalradiation therapy,3DCRT),41例行调强放疗(intensity modulated radiation therapy,IMRT)。手术至放射治疗的间隔时间8~201d,中位时间35d。放疗总剂量30~78Gy,中位剂量60Gy。Kaplan-Meier法进行生存率的计算,Log-rank进行单因素分析,用Cox回归行多因素分析。结果:全组1和3年总生存率分别为74.9%和39.4%,中位生存时间为19.93个月。单因素分析显示,放疗前KPS评分(χ2=4.575,P=0.032)、病理分级(χ2=7.201,P=0.007)、手术切除程度(χ2=18.770,P<0.001)、年龄(χ2=5.245,P=0.022)和术前癫痫发作(χ2=18.356,P<0.001)是影响HGG术后放疗生存率的重要因素。多因素分析显示,病理分级(P=0.001)、放疗前KPS评分(P=0.017)、肿瘤切除情况(P<0.001)和术前癫痫发作(P<0.001)是影响HGG术后放疗1和3年生存率的独立因素。结论:病理分级低、放疗前KPS评分≥80、手术全切和术前癫痫症状均影响GCG患者术后精确放疗的预后。
OBJECTIVE: To retrospectively analyze the prognosis and the influencing factors of precise radiotherapy after high grade glioma (HGG). Methods: A retrospective analysis of Shanxi Cancer Hospital Radiation Oncology Center 2007-09-2012-03 were treated in patients with HGG after 66 cases, were undergone surgical treatment, including 36 cases of macroscopic resection, subtotal resection in 30 cases. Twenty-five patients underwent three-dimensional conformal radiation therapy (3DCRT) and 41 patients underwent intensity modulated radiation therapy (IMRT). Surgery to radiotherapy interval 8 ~ 201d, the median time 35d. Radiation total dose of 30 ~ 78Gy, the median dose of 60Gy. Kaplan-Meier method to calculate the survival rate, Log-rank univariate analysis, Cox regression multivariate analysis. Results: The overall 1-year and 3-year overall survival rates were 74.9% and 39.4%, respectively. The median survival time was 19.93 months. Univariate analysis showed that KPS before radiotherapy (χ2 = 4.575, P = 0.032), pathological grade (χ2 = 7.201, P = 0.007), degree of resection (χ2 = 18.770, P = 0.022) and preoperative epileptic seizures (χ2 = 18.356, P <0.001) were the important factors affecting the survival rate of radiotherapy after HGG. Multivariate analysis showed that pathological grade (P = 0.001), KPS before radiotherapy (P = 0.017), tumor resection (P <0.001) and preoperative seizure (P <0.001) Annual survival rate of independent factors. Conclusion: The pathological grade is low, the KPS score before radiotherapy is 80, and the total and preoperative epilepsy symptoms affect the prognosis of postoperative radiotherapy in GCG patients.