临床神经外科杂志
臨床神經外科雜誌
림상신경외과잡지
JOURNAL OF CLINICAL NEUROSURGERY
2015年
1期
5-8
,共4页
丘脑胶质瘤%放疗%替莫唑胺%预后
丘腦膠質瘤%放療%替莫唑胺%預後
구뇌효질류%방료%체막서알%예후
thalamic gliomas%radiation therapy%Temozolomide%prognosis
目的：探讨调强放疗（ IMRT）联合替莫唑胺（ TMZ）化疗治疗丘脑胶质瘤的疗效，分析影响预后的因素。方法回顾性分析2005年1月～2010年12月联合放化疗治疗的25例丘脑胶质瘤。所有病例治疗前均行立体定向活检明确病理诊断，其中低级别胶质瘤（ WHO Ⅱ级）11例，高级别胶质瘤（ WHO Ⅲ～Ⅴ级）14例。记录治疗反应，计算总体生存率（OS）和无疾病进展生存率（PFS），并应用COX回归模型进行多因素预后分析。结果本组病例急性治疗反应多为Ⅰ～Ⅱ级，没有Ⅲ级以上的反应。同期放化疗结束时，中位KPS上升20。6个月、1年和2年的OS 分别为84．0％、52．0％和22．2％， PFS 分别为76．0％、33．0％和19．8％，中位生存时间为13．0个月（95％ CI 9．5～16．5），中位无进展生存时间9．0个月（95％ CI6．9～11．1）。多因素分析显示，性别、年龄、病程以及放疗前KPS与预后无显著关系，病理级别与预后显著相关。结论调强放疗联合TMZ化疗治疗丘脑胶质瘤的急性反应小，患者能够耐受，近期疗效有改善，但长期疗效仍不理想。
目的：探討調彊放療（ IMRT）聯閤替莫唑胺（ TMZ）化療治療丘腦膠質瘤的療效，分析影響預後的因素。方法迴顧性分析2005年1月～2010年12月聯閤放化療治療的25例丘腦膠質瘤。所有病例治療前均行立體定嚮活檢明確病理診斷，其中低級彆膠質瘤（ WHO Ⅱ級）11例，高級彆膠質瘤（ WHO Ⅲ～Ⅴ級）14例。記錄治療反應，計算總體生存率（OS）和無疾病進展生存率（PFS），併應用COX迴歸模型進行多因素預後分析。結果本組病例急性治療反應多為Ⅰ～Ⅱ級，沒有Ⅲ級以上的反應。同期放化療結束時，中位KPS上升20。6箇月、1年和2年的OS 分彆為84．0％、52．0％和22．2％， PFS 分彆為76．0％、33．0％和19．8％，中位生存時間為13．0箇月（95％ CI 9．5～16．5），中位無進展生存時間9．0箇月（95％ CI6．9～11．1）。多因素分析顯示，性彆、年齡、病程以及放療前KPS與預後無顯著關繫，病理級彆與預後顯著相關。結論調彊放療聯閤TMZ化療治療丘腦膠質瘤的急性反應小，患者能夠耐受，近期療效有改善，但長期療效仍不理想。
목적：탐토조강방료（ IMRT）연합체막서알（ TMZ）화료치료구뇌효질류적료효，분석영향예후적인소。방법회고성분석2005년1월～2010년12월연합방화료치료적25례구뇌효질류。소유병례치료전균행입체정향활검명학병리진단，기중저급별효질류（ WHO Ⅱ급）11례，고급별효질류（ WHO Ⅲ～Ⅴ급）14례。기록치료반응，계산총체생존솔（OS）화무질병진전생존솔（PFS），병응용COX회귀모형진행다인소예후분석。결과본조병례급성치료반응다위Ⅰ～Ⅱ급，몰유Ⅲ급이상적반응。동기방화료결속시，중위KPS상승20。6개월、1년화2년적OS 분별위84．0％、52．0％화22．2％， PFS 분별위76．0％、33．0％화19．8％，중위생존시간위13．0개월（95％ CI 9．5～16．5），중위무진전생존시간9．0개월（95％ CI6．9～11．1）。다인소분석현시，성별、년령、병정이급방료전KPS여예후무현저관계，병리급별여예후현저상관。결론조강방료연합TMZ화료치료구뇌효질류적급성반응소，환자능구내수，근기료효유개선，단장기료효잉불이상。
Objective To investigate the efficacy of intensity modulated radiation therapy (IMRT) combined with Temozolomide ( TMZ) and analyze prognostic factors in the treatment of thalamic gliomas .Methods The clinical data of 25 patients with thalamic gliomas who were treated by radio-chemotherapy from Jan .2005 to Dec.2010 were analyzed retrospectively .All patients were underwent biopsy to verify the pathology before the treatment , 11 were low grade gliomas ( LGG, WHO Ⅱ) and 14 high grade gliomas ( HGG,WHOⅢ-Ⅴ) .We recorded the treatment reaction and calculated the overall survival ( OS ) as well as progression free survival ( PFS ) .The prognostic factors were analyzed by using multivariate COX regression model .Results The acute treatment toxicity were mostly at grade Ⅰ to grade Ⅱ, and no grade Ⅲ or higher adverse reaction was observed .The median KPS was elevated by 20 after the end of concurrent radio-chemotherapy .The OS of 6 months, 1 and 2 years was 84.0%, 52.0%and 22.2%respectively,the PFS was 76%.0, 33.0%and 19.8%respectively.The median overall survival time was 13.0 months(95%CI 9.5-16.5) and the median progression free survival time was 9.0 months (95% CI 6.9-11.1). Multivariate analysis did not reveal the significant correlation of sex , age, duration of symptoms and pre-radiotherapy KPS with the prognosis of the patients , and the grade of histopathology correlated to the prognosis significantly .Conclusion IMRT radiotherapy combine with TMZ chemotherapy has mild and tolerable acute reaction in the treatment of unresected thalamic gliomas , and the short-term efficacy can be improved while the long-term efficacy is still unsatisfactory .
