Grigsby P W, Thomas P R, Schwartz H G, Fineberg B B
Mallinckrodt Institute of Radiology, St. Louis, MO.
Int J Radiat Oncol Biol Phys. 1989 Mar;16(3):649-55. doi: 10.1016/0360-3016(89)90480-x.
A multivariate analysis of prognostic variables was performed on a retrospective review of 136 patients with presumed or histologically proven primary lesions of the thalamus and brainstem treated by combined surgery and post-operative irradiation or by irradiation alone from January 1950 through December 1983. Overall survival for all patients at 5 and 10 years was 34.4 and 27.8%, respectively. Follow-up of 33 living patients ranged from 3 to 22 years. Prognostic variables analyzed by univariate analysis and found to be of significance (p less than 0.05) were race, duration of symptoms, extent of surgery (i.e. subtotal excision), and dose of irradiation. Further evaluation by Cox regression analysis revealed these same factors to be of prognostic significance (p less than 0.05). It is of importance to note that age and tumor site were not significant prognostic variables in the multivariate analysis but were significant by univariate analysis. The 5-year overall survival for patients with thalamic tumors was 59.5 and 20.9% for children and adults, respectively (p = 0.006). The 5-year overall survival for patients with pontine lesions was 46.6 and 16.0% for adults and children, respectively (p = 0.01). Only one patient was known to have expired due to a complication of therapy. Neurologic deficits and functional ability was normal or mild in 57.6% of the surviving patients.
对1950年1月至1983年12月期间接受联合手术及术后放疗或单纯放疗的136例丘脑和脑干原发性病变患者（包括临床诊断或组织学确诊病例）进行回顾性研究，分析预后变量的多因素情况。所有患者5年和10年的总生存率分别为34.4%和27.8%。对33例存活患者的随访时间为3至22年。单因素分析发现具有统计学意义（p<0.05）的预后变量有种族、症状持续时间、手术范围（即次全切除）和放疗剂量。Cox回归分析进一步评估显示这些因素同样具有预后意义（p<0.05）。需要注意的是，年龄和肿瘤部位在多因素分析中并非显著的预后变量，但在单因素分析中具有统计学意义。丘脑肿瘤患者中儿童和成人的5年总生存率分别为59.5%和20.9%（p = 0.006）。桥脑病变患者中成人和儿童的5年总生存率分别为46.6%和16.0%（p = 0.01）。已知仅1例患者因治疗并发症死亡。57.6%的存活患者神经功能缺损和功能能力正常或轻度受损。
