CAJ | 학술논문

目的:探讨高度恶性脑胶质瘤的预后以及预后影响因素.方法:回顾分析江西省肿瘤医院2005年4月至2011年2月收治的89例高度恶性脑胶质瘤的临床资料,其中手术全切43例,部分切除46例;WHO3级45例,4级44例.结果:全组中位生存期13个月,2年总生存率(OS)及无进展生存率(PFS)分别为43.2%和36.9%;单因素分析显示切除程度、病理分级、年龄是OS的影响因素(P<0.05),切除程度、脑室系统受侵、术后放疗是PFS的影响因素(P<0.05),多因素分析结果显示切除程度、年龄是OS的独立影响因素(P<0.05);切除程度、术后放疗是PFS的独立影响因素(P<0.05);全组共41例复发,其中原位复发65.9%,远隔部位复发34.1%;46例脑室系统受侵者,11例出现远隔部位复发;其余43例,仅3例出现远隔部位复发.结论:手术切除程度、年龄是影响OS的独立预后因素,术后放疗能改善PFS;原位复发是主要复发模式,脑室受侵增加了远处播散概率.
목적:탐토고도악성뇌효질류적예후이급예후영향인소.방법:회고분석강서성종류의원2005년4월지2011년2월수치적89례고도악성뇌효질류적림상자료,기중수술전절43례,부분절제46례;WHO3급45례,4급44례.결과:전조중위생존기13개월,2년총생존솔(OS)급무진전생존솔(PFS)분별위43.2%화36.9%;단인소분석현시절제정도、병리분급、년령시OS적영향인소(P<0.05),절제정도、뇌실계통수침、술후방료시PFS적영향인소(P<0.05),다인소분석결과현시절제정도、년령시OS적독립영향인소(P<0.05);절제정도、술후방료시PFS적독립영향인소(P<0.05);전조공41례복발,기중원위복발65.9%,원격부위복발34.1%;46례뇌실계통수침자,11례출현원격부위복발;기여43례,부3례출현원격부위복발.결론:수술절제정도、년령시영향OS적독립예후인소,술후방료능개선PFS;원위복발시주요복발모식,뇌실수침증가료원처파산개솔.
Objective: This study discusses the prognosis and prognostic factors of postoperative high-grade glioma. Methods:Eighty-nine patients with postoperative high-grade glioma were registered at the Jiangxi Province Tumor Hospital between April 2005 and February 2011. Total and partial removal of glioma were performed in 43 and 46 patients, respectively. Based on the World Health Orga-nization (WHO) grading system of glioma, 45 patients in this study had WHO gradeⅢglioma and 44 patients had WHO grade IV glioma. Results: The results show that the median survival time of patients with glioma was 13 months. The two-year overall survival rate (OS) was 43.2%, and the two-year progression-free survival rate (PFS) was 36.9%. The prognostic factors of OS identified in univariate analysis include age, pathological grade, and resection extent (P<0.05). However, the independent prognostic factors in multivariate analysis only include resection extent and age (P<0.05). The prognostic factors of PFS in univariate analysis include resection extent, postoperative radiotherapy, and ventricle violated before surgery (P<0.05). However, the independent prognostic factors in multivariate analysis only include resection extent and postoperative radiotherapy (P<0.05). In this study, tumor recurrence occurred in 41 patients, 65.9% patients had tumor bed failure, and 34.1% had distance failure. Among the 46 patients with damaged ventricles before surgery, 11 displayed distant recurrence. Among the 43 patients who underwent total removal of glioma, 3 had distant metastasis before surgery Conclusion: Resection extent and age are the independent prognostic factors of overall survival in glioma, and postoperative radiotherapy can improve the progression-free survival of patients. The major pattern of failure is tumor bed recurrence. However, distance failure increases when the ventricle is damaged.