Li Weichang, Zhang Ruiming, Yang Jisheng, Wang Ruili
Department of Radiology, Yidu Central Hospital of Weifang, Weifang, Shandong 262500, P.R. China.
Department of Medical Image, Shandong Provincial Chest Hospital, Jinan, Shandong 250013, P.R. China.
Oncol Lett. 2017 Dec;14(6):7201-7206. doi: 10.3892/ol.2017.7138. Epub 2017 Oct 4.
This study evaluated the efficacy of surgery combined with I seed implantation in the treatment of recurrent glioma, and analyzed prognosis-influencing factors. A total of 66 patients with recurrent gliomas in Yidu Central Hospital of Weifang were enrolled in the study from April, 2011 to March, 2014. Patients were randomly divided into a control and an observation group, with 33 patients in each group. Patients in the control group were treated with surgery alone, and those in the observation group received surgery combined with I seed implantation. Short-term curative effects in the two groups were compared using evaluation criteria for solid tumors. The comparison included the postoperative adverse reactions, the life quality (using the Karnofsky Performance Status or KPS), the survival time and prognostic factors (using the Kaplan-Meier survival, log-rank test and Cox regression analyses). Our results showed the objective response and disease control rates in the observation group were significantly higher than those in the control group (P<0.05). While no significant differences in postoperative adverse reactions were found between the two groups (P>0.05). The KPS score in the observation group was significantly higher than that in the control group at different time points after surgery (P<0.05). The survival rate and overall survival time of those in the observation group were significantly higher than those of the patients in the control group (P<0.05). The univariate analysis showed that preoperative KPS score, tumor pathological grade and degree of tumor resection were adverse factors influencing the prognosis of the patients (P<0.05). Also, multivariate Cox regression showed that preoperative KPS score, tumor pathological grade, and degree of tumor resection were independent risk factors of prognosis. Based on our findings, surgery combined with I seed implantation can improve the survival rate of patients with recurrent glioma and prolong their survival time. Tumor pathological grade, degree of tumor resection and KPS score are the most important factors influencing the prognosis.
本研究评估了手术联合碘-125粒子植入治疗复发性胶质瘤的疗效,并分析了预后影响因素。2011年4月至2014年3月,潍坊益都中心医院共纳入66例复发性胶质瘤患者。患者被随机分为对照组和观察组,每组33例。对照组患者仅接受手术治疗,观察组患者接受手术联合碘-125粒子植入治疗。采用实体瘤疗效评价标准比较两组的短期疗效。比较内容包括术后不良反应、生活质量(采用卡氏功能状态评分或KPS评分)、生存时间和预后因素(采用Kaplan-Meier生存分析、log-rank检验和Cox回归分析)。结果显示,观察组的客观缓解率和疾病控制率显著高于对照组(P<0.05)。两组术后不良反应无显著差异(P>0.05)。观察组术后不同时间点的KPS评分显著高于对照组(P<0.05)。观察组的生存率和总生存时间显著高于对照组患者(P<0.05)。单因素分析显示,术前KPS评分、肿瘤病理分级和肿瘤切除程度是影响患者预后的不利因素(P<0.05)。多因素Cox回归分析显示,术前KPS评分、肿瘤病理分级和肿瘤切除程度是预后的独立危险因素。根据研究结果,手术联合碘-125粒子植入可提高复发性胶质瘤患者的生存率,延长其生存时间。肿瘤病理分级、肿瘤切除程度和KPS评分是影响预后的最重要因素。