Abdel-Wahab M, Corn B, Wolfson A, Raub W, Gaspar L E, Curran W, Bustillo P, Rubinton P, Markoe A
Jackson Memorial Hospital, University of Miami, Florida, USA.
Am J Clin Oncol. 1999 Aug;22(4):344-51. doi: 10.1097/00000421-199908000-00004.
The purpose of this study was to determine the impact of various prognostic factors on survival in spinal cord gliomas treated with radiation. Fifty-three patients with spinal cord gliomas irradiated at three major institutions were studied. Fifty-one patients were classified as having ependymoma, astrocytoma, or both. Two patients were classified as having gliomas (otherwise unspecified). Eleven patients had complete resection of their tumor. Biopsy or partial resection was done in the remaining patients. All patients received external beam radiation. Information on these patients was placed in a central database file and analyzed for the effect of several prognostic factors on survival. Overall survival of the entire group was 76.9% and 61.5% at 5 and 10 years, respectively. Pathologic status significantly affected survival (p = 0.03). Patients with ependymomas had a 5-year survival of 93.8% and a 10-year survival of 67.5%. Patients with astrocytoma had a 5-year survival of 64.2% and a 10-year survival of 54%. Univariate analysis showed pathology and the presence of cysts (p = 0.038) to significantly affect survival. Age, sex, location of the primary, extent of surgery radiation dose, and number of involved segments did not affect survival. On multivariate analysis, astrocytic pathology, involvement of more than five segments, male sex, and the absence of cysts (in or adjacent to the tumor) were associated with a significantly inferior survival. This study confirms the importance of pathology and number of segments involved in determining outcome or survival. The presence of cysts adjacent to or within the tumor was found to be associated with an improvement in survival.
本研究的目的是确定各种预后因素对接受放疗的脊髓胶质瘤患者生存情况的影响。对在三家主要机构接受放疗的53例脊髓胶质瘤患者进行了研究。51例患者被分类为患有室管膜瘤、星形细胞瘤或两者皆有。2例患者被分类为患有胶质瘤（未另行明确说明）。11例患者肿瘤完全切除。其余患者进行了活检或部分切除。所有患者均接受了外照射放疗。将这些患者的信息录入中央数据库文件，并分析了几种预后因素对生存情况的影响。整个组的5年和10年总生存率分别为76.9%和61.5%。病理状态显著影响生存情况（p = 0.03）。室管膜瘤患者的5年生存率为93.8%，10年生存率为67.5%。星形细胞瘤患者的5年生存率为64.2%，10年生存率为54%。单因素分析显示病理状态和囊肿的存在（p = 0.038）对生存情况有显著影响。年龄、性别、原发部位、手术范围、放疗剂量和受累节段数均不影响生存情况。多因素分析显示，星形细胞病理、超过五个节段受累、男性以及无囊肿（肿瘤内或肿瘤旁）与生存率显著降低相关。本研究证实了病理状态和受累节段数在决定预后或生存情况方面的重要性。发现肿瘤旁或肿瘤内存在囊肿与生存率提高相关。
