Lai D M, Lin S M, Tu Y K, Kao M C, Hung C C
Department of Surgery, College of Medicine, National Taiwan University, Taipei, R.O.C.
J Formos Med Assoc. 1993 Mar;92(3):220-6.
Maximum feasible resection of the tumor followed by 50 Gy whole brain irradiation was the routine management for patients with malignant glioma in this series. To determine treatment results and possible prognostic factors, a retrospective analysis was done of 116 patients with pathologically proven supratentorial malignant astrocytomas (71 glioblastoma multiforme and 45 anaplastic astrocytoma) from January 1981 to December 1990. The mean age of the patients at the time of diagnosis was 46 years for glioblastoma multiforme and 37 years for anaplastic astrocytoma. In 86% of the patients, their condition improved or was constant after surgery; in 14% of the patients, the conditions worsened. The median survival time was 10 months for patients with glioblastoma multiforme and 22 months for those with anaplastic astrocytoma. Cox regression analysis showed that the duration of symptoms, extent of resection, irradiation and tumor histology were significantly related to the survival time. However, gross total resection did not improve the survival time relative to a subtotal resection, although both were shown to be better than a partial resection or biopsy.
在本系列研究中，对恶性胶质瘤患者的常规治疗方法是先尽可能最大程度地切除肿瘤，然后进行50 Gy的全脑照射。为了确定治疗效果和可能的预后因素，对1981年1月至1990年12月期间116例经病理证实的幕上恶性星形细胞瘤患者（71例多形性胶质母细胞瘤和45例间变性星形细胞瘤）进行了回顾性分析。多形性胶质母细胞瘤患者诊断时的平均年龄为46岁，间变性星形细胞瘤患者为37岁。86%的患者术后病情改善或稳定；14%的患者病情恶化。多形性胶质母细胞瘤患者的中位生存时间为10个月，间变性星形细胞瘤患者为22个月。Cox回归分析表明，症状持续时间、切除范围、放疗和肿瘤组织学与生存时间显著相关。然而，相对于次全切除，全切除并未改善生存时间，尽管两者均显示优于部分切除或活检。
