| 恶性脑胶质瘤术后放疗与同步放化疗的疗效对比及影响因素分析 |
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| 引用本文： | 田碧,孙旭东,马建,李朋朋,时昌立,丁广成,秦德华,卜亚静.恶性脑胶质瘤术后放疗与同步放化疗的疗效对比及影响因素分析[J].现代肿瘤医学,2022,0(4):607-612. |
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| 作者姓名： | 田碧 孙旭东 马建 李朋朋 时昌立 丁广成 秦德华 卜亚静 |
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| 作者单位： | 郑州大学第五附属医院伽玛刀中心,河南 郑州 450000 |
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| 摘 要： | 目的:探讨三维适形放疗（three-dimensional conformal radiation therapy，3DCRT）联合替莫唑胺（temozolomide，TMZ）治疗恶性脑胶质瘤预后影响因素。方法:回顾分析 2012年01月至2015年06月在我院就诊的120例恶性脑胶质瘤患者的病例资料，所有患者均接受颅内肿瘤切除术，其中术后行3DCRT 56例（放疗组），术后行3DCRT联合TMZ胶囊口服治疗64例（放化疗组），比较两组治疗方式的疗效，并采用Kaplan-Meier 法进行生存分析，通过单因素分析和Cox回归模型多因素分析探讨影响恶性脑胶质瘤患者预后的独立影响因素。结果:放化疗组患者的1年生存率和2年生存率分别为88.33%、79.68%，显著高于放疗组的78.57%、55.36%（P＜0.05），放化疗组中位生存时间显著长于放疗组（28.4 月vs 21.3月），放化疗组中位无进展生存期（median progression-free survival，mPFS）显著长于放疗组（20.1月vs 16.5月）；Ⅲ级患者1年生存率和2年生存率分别为93.33%、82.54%，显著高于Ⅳ级患者的75.00%、54.29%（P＜0.05），且Ⅲ级患者中位生存时间显著长于Ⅳ级（54.5月vs 17.8月），Ⅲ级患者mPFS显著长于Ⅳ级（32.4月vs 14.6月）（P＜0.05）。单因素分析结果表明年龄、病理分级、术前KPS评分、术前瘤周水肿程度、肿瘤切除程度、肿瘤部位、病灶数量是影响恶性脑胶质瘤患者中位生存时间的显著因素（P值均<0.05）。多因素分析结果表明年龄、病理分级以及患者术前KPS评分是影响恶性脑胶质瘤患者术后生存的独立危险因素。结论:放疗联合TMZ化疗可以显著延长恶性脑胶质瘤患者的中位生存期，恶性脑胶质瘤患者预后与患者年龄、病理分级以及术前KPS评分存在显著相关性。
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| 关 键 词： | 三维适形放疗 替莫唑胺 恶性脑胶质瘤 预后 影响因素 |
Comparison of efficacy and analysis of factors affecting prognosis of malignant glioma treated with radiotherapy and concurrent chemoradiotherapy |
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| TIAN Bi,SUN Xudong,MA Jian,LI Pengpeng,SHI Changli,DING Guangcheng,QIN Dehua,BU Yajing.Comparison of efficacy and analysis of factors affecting prognosis of malignant glioma treated with radiotherapy and concurrent chemoradiotherapy[J].Journal of Modern Oncology,2022,0(4):607-612. |
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| Authors: | TIAN Bi SUN Xudong MA Jian LI Pengpeng SHI Changli DING Guangcheng QIN Dehua BU Yajing |
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| Affiliation: | Gamma Knife Center,the Fifth Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450000,China. |
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| Abstract: | Objective:To investigate the prognostic factors of three-dimensional conformal radiation therapy(3DCRT)combined with temozolomide(TMZ)in the treatment of malignant glioma.Methods:The clinical data of 120 cases of malignant glioma patients in our hospital from January 2012 to June 2015 were retrospectively analysed.All patients underwent intracranial tumor resection,including 3DCRT in 56 patients(radiotherapy group),postoperative 3DCRT combined with TMZ oral treatment in 64 patients(chemoradiotherapy group).The efficacy of the two groups of treatment were compared,and survival analysis was performed using the Kaplan-Meier method,and univariate analysis and Cox regression multivariate analysis were used to investigate the independent influencing factors affecting the prognosis of patients with malignant glioma.Results:The 1-year survival rate and 2-year survival rate of the patients in the chemoradiotherapy group were 88.33%and 79.68%,respectively,which were significantly higher than that of the radiotherapy group(78.57%,55.36%,P<0.05),and the median survival time of the chemoradiotherapy group was significantly longer than that of the radiotherapy group(28.4 months vs 21.3 months).The median progression-free survival(mPFS)of the chemoradiotherapy group was significantly longer than that of the radiotherapy group(20.1 months vs 16.5 months).The 1-year survival rate and 2-year survival rate of gradeⅢpatients were 93.33%and 82.54%,respectively,which were significantly higher than those of gradeⅣpatients(75.00%,54.29%,P<0.05),and the median survival time of gradeⅢpatients was significantly longer than that of gradeⅣ(54.5 months vs 17.8 months).And the mPFS of gradeⅢpatients was significantly longer than that of gradeⅣ(32.4 months vs 14.6 months)(P<0.05).Univariate analysis showed that age,pathological grade,preoperative KPS score,peritumoral edema,degree of surgical resection,tumor site,and number of lesions were significant factors affecting the median survival time of patients with malignant glioma(P<0.05).Multivariate analysis results indicated that age,pathological grade,and preoperative KPS score were independent risk factors for postoperative survival in patients with malignant glioma.Conclusion:Radiotherapy combined with TMZ chemotherapy can significantly prolong the median survival of patients with malignant glioma.The prognosis of patients with malignant glioma is significantly correlated with age,pathological grade and preoperative KPS score. |
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| Keywords: | three-dimensional conformal radiation therapy temozolomide malignant glioma prognosis influencing factors |
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