Shaw E G, Scheithauer B W, O'Fallon J R, Davis D H
Division of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
Neurosurgery. 1994 Apr;34(4):577-82; discussion 582. doi: 10.1227/00006123-199404000-00002.
Seventy-one patients with supratentorial mixed oligoastrocytomas underwent surgery only (5 patients) or surgery with postoperative radiation therapy (66 patients) between 1960 and 1982. The median survival for these 71 patients was 5.8 years and the 5-, 10-, and 15-year survival rates were 55, 29, and 17%, respectively--values significantly different from those of an age- and sex-matched normal reference population. Uni- and multivariate survival analyses were applied to 14 possible prognostic factors, including the following: patient factors--age, sex, and seizures; tumor factors--site, size, side, computed tomographic enhancement, and calcification; pathological factors--tumor grade and dominant cellular component; and treatment factors--extent of surgical resection, lobectomy, and radiation dose and field. Of these factors, tumor grade, as determined by the Kernohan method, was the most strongly associated with survival. The 60 patients with Grades 1 and 2 tumors had a median survival of approximately 6.3 years and 5- and 10-year survival rates of 58% and 32%, respectively, compared with 2.8 years (36 and 9%, respectively) for the 11 patients with Grades 3 and 4 tumors. Age < 37 years, gross total resection, partial brain radiation, and radiation dose > or = 5000 cGy were other factors significantly associated with improved survival in both uni- and multivariate models. Three of five patients not receiving postoperative radiation therapy experienced tumor recurrence and died. Seven of eight patients from whom tissue was obtained at the time of tumor progression demonstrated anaplastic transformation.(ABSTRACT TRUNCATED AT 250 WORDS)
1960年至1982年间，71例幕上混合性少突星形细胞瘤患者仅接受了手术治疗（5例）或术后放疗（66例）。这71例患者的中位生存期为5.8年，5年、10年和15年生存率分别为55%、29%和17%，这些数值与年龄和性别匹配的正常参考人群有显著差异。对14个可能的预后因素进行了单因素和多因素生存分析，包括以下因素：患者因素——年龄、性别和癫痫发作；肿瘤因素——部位、大小、侧别、计算机断层扫描增强和钙化；病理因素——肿瘤分级和主要细胞成分；以及治疗因素——手术切除范围、叶切除术、放疗剂量和照射野。在这些因素中，根据克诺汉方法确定的肿瘤分级与生存最密切相关。60例1级和2级肿瘤患者的中位生存期约为6.3年，5年和10年生存率分别为58%和32%，而11例3级和4级肿瘤患者的中位生存期为2.8年（5年和10年生存率分别为36%和9%）。年龄<37岁、全切除、局部脑放疗以及放疗剂量≥5000 cGy是单因素和多因素模型中与生存改善显著相关的其他因素。5例未接受术后放疗的患者中有3例出现肿瘤复发并死亡。8例在肿瘤进展时获取组织的患者中有7例显示间变转化。（摘要截断于250字）
