Wu Shao-Xiong, Deng Mei-Ling, Li Qiao-Qiao, Zhao Chong, Lu Tai-Xiang, Li Feng-Yan, Cui Nian-Ji
Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou,Guangdong,510060, P.R.China.
Ai Zheng. 2004 Nov;23(11 Suppl):1561-6.
BACKGROUND & OBJECTIVE: Surgery is the major treatment for glioma, and radiotherapy is often needed after operation. This study was to evaluate prognostic factors of patients with cerebral glioma treated with radiotherapy.
Records of 158 patients with cerebral glioma, including 123 patients with astrocytoma (AC), 12 patients with oligodendroglioma (OD) or mixed oligoastrocytoma (OA), and 23 patients with glioblastoma multiforme (GBM), received radiotherapy in our center were analyzed. Eighty patients received total resection, 77 received subtotal resection, and 1 received biopsy before radiotherapy. Median radiation dose was 58 Gy (36-75 Gy). Median waiting time from operation to radiotherapy was 29 days (12-261 days). Sixty-eight patients received chemotherapy before or after radiotherapy. Cox model was used for univariate and multivariate analysis.
Median follow-up was 23 months (2-62 months), 27 patients relapsed, and 57 patients died. The 2- and 4-year overall survival rate were 66.5% and 45.7%. Univariate analysis showed that histologic grade (I/II vs. II/IV), histologic type (AC/OD vs. GBM), Karnofsky performance state (KPS) before radiotherapy (>/=80 vs.< 80), extent of resection (total vs non-total), and age(</=40 years vs. >40 years) were significant predictors in association with overall survival rate of patients with glioma. Multivariate analysis showed that histologic grade (P=0.001), age (P=0.006), KPS before radiotherapy (P=0.009), and extent of resection (P=0.037) were independent prognostic factors of glioma.
Low grade (I/II), age </=40 years, KPS>/=80 before radiotherapy, and total resection are independent factors for predicting better survival of glioma patients.
手术是胶质瘤的主要治疗方法,术后常需放疗。本研究旨在评估接受放疗的脑胶质瘤患者的预后因素。
分析了在本中心接受放疗的158例脑胶质瘤患者的记录,其中包括123例星形细胞瘤(AC)患者、12例少突胶质细胞瘤(OD)或混合性少突星形细胞瘤(OA)患者以及23例多形性胶质母细胞瘤(GBM)患者。80例患者接受了全切除,77例接受了次全切除,1例在放疗前接受了活检。中位放射剂量为58 Gy(36 - 75 Gy)。从手术到放疗的中位等待时间为29天(12 - 261天)。68例患者在放疗前或放疗后接受了化疗。采用Cox模型进行单因素和多因素分析。
中位随访时间为23个月(2 - 62个月),27例患者复发,57例患者死亡。2年和4年总生存率分别为66.5%和45.7%。单因素分析显示,组织学分级(I/II级与III/IV级)、组织学类型(AC/OD与GBM)、放疗前卡氏功能状态(KPS)(≥80与<80)、切除范围(全切除与非全切除)以及年龄(≤40岁与>40岁)是与胶质瘤患者总生存率相关的显著预测因素。多因素分析显示,组织学分级(P = 0.001)、年龄(P = 0.006)、放疗前KPS(P = 0.009)以及切除范围(P = 0.037)是胶质瘤的独立预后因素。
低级别(I/II级)、年龄≤40岁、放疗前KPS≥80以及全切除是预测胶质瘤患者更好生存的独立因素。