WHOⅢ级胶质瘤患者放疗或联合化疗治疗的预后因素分析

Prognostic factors of WHO Ⅲ grade glioma patients treated with radiotherapy or chemotherapy

摘要:

目的：研究WHOⅢ级胶质瘤患者放疗或联合化疗治疗后的预后因素。方法：本组59例胶质瘤患者被纳入研究。所有患者手术后6个星期内开始总平均剂量为59.4 Gy的放疗，放疗之后4个星期内开始接受化疗。根据术后治疗方案分为单独放疗组和放疗加化疗组，所有患者治疗结束后均定期随访。生存质量采用Kaplan-Meyer法计算生存率并采用Log秩检验；多因素分析使用Cox比例风险模型。结果：总体生存期延长受年龄、良好体力状态、间变性少突胶质细胞瘤的组织学诊断、完全切除或放疗后加辅助PCV化疗独立影响。基于终末节点的中位生存期，可将研究对象分为4组。不依赖于组织学诊断，完全切除术后给予放疗加PCV化疗治疗的患者或不完全切除但具有最佳体力状态（ECOG评分0级）的患者可预期达到更长的生存期。基于术后临床环境，使用目前的结果可估算生存概率。结论：分组可以成功预测WHOⅢ级胶质瘤患者的生存期。体力状态、切除范围、组织学诊断和治疗方式是患者生存期的主要决定因素。

Abstract:

Objective：To study the prognostic factors of WHO Ⅲ grade glioma patients treated with radiotherapy or chemotherapy. Methods：Totally 59 gliomas patients were included in this study. All patients within six weeks after the operation began radiotherapy with total average dose of 59.4 Gy and received chemotherapy at four weeks after radiotherapy. They were divided into radiotherapy （RT） group and combined radiochemotherapy（RCT） group according to their treatment methods after the operation. All patients were followed up periodically after treatment. Survival probabilities were estimated based on Kaplan-Meyer survival analysis and Log rank test. Cox proportional-hazards model was used for multivariate regression analysis. Results：The prolonged overall survival time was affected by age，good physical condition，anaplastic oligodentrocytoma histological diagnosis，complete resection or radiotherapy plus PCV chemotherapy. Based on the median survival time of the terminal node，all patients in this study were divided into four groups. Patients received radiotherapy plus PCV chemotherapy after complete resection without depending on histological diagnosis and those with incomplete resection but the best physical condition（ECOG score was 0 grade） can be expected to achieve a longer lifetime. Based on the postoperative clinical environment，the current results can be used to estimate the probability of survival. Conclusions：The grouping can successfully predict the survival time of patients with WHO Ⅲ grade glioma. Physical condition，extent of resection，his－tological diagnosis and treatment methods are the major determinants for the survival time of patients.