Wang Jiancun, Hu Guancheng, Quan Xingyun
Department of Neurosurgery, Zhangjiajie People's Hospital, 192 Guyong road, Zhangjiajie, Hunan, China 427000.
Open Med (Wars). 2019 Apr 4;14:331-335. doi: 10.1515/med-2019-0031. eCollection 2019.
This retrospective study was carried out to investigate factors affecting the prognosis of gliomas for better management of treatment. Clinical data from 186 glioma patients treated in our hospital from January 2013 to June 2016 were analyzed. There was slightly more male than female patients in the cohort. The main clinical symptoms included sudden limb twitching, headache and fatigue, vomiting, vision reduction and speaking disorders. The malignancy was high and the prognosis was poor in the patients, with an overall survival rate of 54.84 % by October 2017. Univariate analysis showed that the prognosis was mainly affected by age, tumor grade, preoperative Karnofsky performance status (KPS), surgical method, postoperative radiotherapy and chemotherapy, and postoperative use of temozolomide (TMZ). Multivariate Cox regression analysis showed that the independent risk factors for the prognosis were old age (≥ 60), advanced tumor, partial tumor resection, KPS of < 70, no chemotherapy after operation and < 4 courses of postoperative TMZ. The prognosis is negatively affected by age, tumor grade, KPS, and partial tumor resection. Surgical resection combined with chemotherapy and multi-course use of TMZ prolongs the survival time of patients.
本回顾性研究旨在调查影响胶质瘤预后的因素,以便更好地管理治疗。分析了2013年1月至2016年6月在我院接受治疗的186例胶质瘤患者的临床资料。该队列中男性患者略多于女性患者。主要临床症状包括突发肢体抽搐、头痛和乏力、呕吐、视力减退及言语障碍。患者恶性程度高,预后差,截至2017年10月总生存率为54.84%。单因素分析显示,预后主要受年龄、肿瘤分级、术前卡氏评分(KPS)、手术方式、术后放疗和化疗以及术后替莫唑胺(TMZ)的使用影响。多因素Cox回归分析显示,预后的独立危险因素为年龄较大(≥60岁)、肿瘤进展、肿瘤部分切除、KPS<70、术后未化疗以及术后TMZ使用<4个疗程。年龄、肿瘤分级、KPS和肿瘤部分切除对预后有负面影响。手术切除联合化疗及多疗程使用TMZ可延长患者生存时间。