Ayoubi S, Walter P H, Naik S, Sankaran M, Robinson D
Department of Neurosurgery, Hurstwood Park Neurological Centre, Haywards Heath, UK.
Br J Neurosurg. 1993;7(1):61-9. doi: 10.3109/02688699308995057.
A retrospective study of 139 glioma patients was conducted in an effort to audit management. Factors affecting survival were studied using a Cox Proportional Hazard Model. These factors included age, sex, location, grade, type of surgery, use of radiotherapy, presenting symptoms, Karnofsky score on admission and Karnofsky score 3 months following surgery. Lower grade, high Karnofsky score on admission, radiotherapy and frontal location were associated with better survival. There was statistically insignificant evidence that the other factors had an influence on survival. Patients presenting with a poor neurological score were treated with burrhole biopsy alone. Only 10% of these patients survived more than 6 months. On the other hand, 26% of patients who had craniotomy on the basis of reasonable clinical status lived less than 6 months. Sixty-six per cent of patients in this craniotomy group were aged 60 years or over, and 66% of those aged over 60 had a Karnofsky score of less than 70. We conclude that careful judgement is required before subjecting patients aged over 60, especially those with a low Karnofsky score, to radical therapy.
对139例胶质瘤患者进行了一项回顾性研究，以审核治疗管理情况。使用Cox比例风险模型研究了影响生存的因素。这些因素包括年龄、性别、位置、分级、手术类型、放疗的使用、出现的症状、入院时的卡氏评分以及术后3个月的卡氏评分。低分级、入院时高卡氏评分、放疗和额叶位置与较好的生存相关。没有统计学意义的证据表明其他因素对生存有影响。神经学评分差的患者仅接受钻孔活检治疗。这些患者中只有10%存活超过6个月。另一方面，基于合理临床状态进行开颅手术的患者中有26%存活不到6个月。该开颅手术组中66%的患者年龄在60岁及以上，60岁以上患者中有66%的卡氏评分低于70。我们得出结论，在对60岁以上患者，尤其是卡氏评分低的患者进行根治性治疗之前，需要谨慎判断。
