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目的:回顾总结43例脑胶质瘤术后放疗的病例,分析影响预后的因素。方法:1988年3月至1992年12月,43例经术后病理证实为脑胶质瘤的病例。其中手术部分切除37例(86%),肉眼全切6例(14%),术后放疗采用60Coγ线。放射剂量为30~60Gy,常规分割。结果:43例总5年生存率256%,高分级组1、3、5年生存率分别为72%、20%、12%,低分级组的1、3、5年生存率分别为722%、611%、444%,两组的3、5年生存率比较有显著差异(P<005)。高分级组中,高剂量组的1、3、5年生存率分别为938%、313%、188%,低剂量组的1、3、5年生存率为444%、0%、0%,两组生存率有显著差异(P<005)。低分级组中,高剂量组的1、3、5年生存率分别为917%、75%、583%,低剂量组的1、3、5年生存率分别为50%、333%、167%,两组间只有5年生存率有显著差异(P<005)。结论:影响脑胶质瘤预后的因素主要为病理分级及术后放疗的放射剂量。为提高疗效,术后放疗放射剂量应达55~60Gy。
OBJECTIVE: To retrospectively summarize 43 cases of postoperative radiotherapy of glioma and analyze the factors that influence the prognosis. Methods: From March 1988 to December 1992, 43 cases of brain glioma were confirmed by postoperative pathology. Among them, 37 cases (86%) were partially removed by surgery, 6 cases (14%) were totally cut by the naked eye, and 60Co gamma rays were used for postoperative radiotherapy. Radiation dose is 30 ~ 60Gy, conventional segmentation. Results: The total 5-year survival rate was 43% in 43 patients, and the 1-, 3-, and 5-year survival rates were 72%, 20%, and 12% in the high-grade group. The 1-, 3-, and 5-year survival rates in the low-grade group were 72. 2%, 61. 1%, 44. 4%. The 3 and 5-year survival rates of the two groups were significantly different (P <0. 05). In the high-grade group, the 1-, 3-, and 5-year survival rates of the high-dose group were 93.8%, 31.8%, and 18.8%, respectively. The 1-, 3-, and 5-year survival rates of the low-dose group were 44.4%. %, 0%, 0%, there was a significant difference in survival rate between the two groups (P<005). In the low-grade group, the 1-, 3-, and 5-year survival rates of the high-dose group were 91.7%, 75%, and 58.4%, respectively. The 1-, 3-, and 5-year survival rates of the low-dose group were 50% and 33. 3%, 167%, only 5-year survival rate was significantly different between the two groups (P<005). Conclusion: The main factors influencing the prognosis of gliomas are pathological grade and radiation dose after radiotherapy. In order to improve the curative effect, postoperative radiotherapy radiation dose should reach 55 ~ 60Gy.