中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2015年
3期
239-243
,共5页
朱琳%章婧文%王慧%吴德华
硃琳%章婧文%王慧%吳德華
주림%장청문%왕혜%오덕화
髓母细胞瘤%放射治疗%化学疗法%回顾性分析%预后
髓母細胞瘤%放射治療%化學療法%迴顧性分析%預後
수모세포류%방사치료%화학요법%회고성분석%예후
Medulloblastoma%Radiotherapy%Chemotherapy%Retrospective analysis%Prognosis
目的 比较手术联合放疗与放化疗对髓母细胞瘤患者生存率的影响,分析影响其预后的相关因素. 方法 回顾性分析南方医科大学南方医院自2002年6月至2014年1月收治的79例髓母细胞瘤患者的临床资料,比较术后放化疗与术后单纯放疗对髓母细胞瘤患者5年生存率、无瘤生存率的影响,Cox回归模型分析影响髓母细胞瘤患者预后的相关因素. 结果 本组患者中74例行肿瘤全切术,5例行次全切术;术后单纯放疗41例,术后放化疗38例.术后单独放疗与术后放化疗患者的5年生存率(73.2％vs 81.6％)、无瘤生存率(65.9％vs 76.3％)比较差异均无统计学意义(P＜0.05).有术后肿瘤残留和复发转移、是高风险人群的患者5年生存率分别低于无术后残留、非高风险人群患者,差异均有统计学意义(P＜0.05); Cox回归模型表明,高风险人群相对危险度[(RR)=22.461,P=0.038]、复发转移(RR=65.547,P=0.000)是影响髓母细胞瘤预后的独立危险因素. 结论 髓母细胞瘤的治疗首选手术切除+术后放射治疗.属于高风险人群、有复发转移的髓母细胞瘤患者预后较差.
目的 比較手術聯閤放療與放化療對髓母細胞瘤患者生存率的影響,分析影響其預後的相關因素. 方法 迴顧性分析南方醫科大學南方醫院自2002年6月至2014年1月收治的79例髓母細胞瘤患者的臨床資料,比較術後放化療與術後單純放療對髓母細胞瘤患者5年生存率、無瘤生存率的影響,Cox迴歸模型分析影響髓母細胞瘤患者預後的相關因素. 結果 本組患者中74例行腫瘤全切術,5例行次全切術;術後單純放療41例,術後放化療38例.術後單獨放療與術後放化療患者的5年生存率(73.2％vs 81.6％)、無瘤生存率(65.9％vs 76.3％)比較差異均無統計學意義(P＜0.05).有術後腫瘤殘留和複髮轉移、是高風險人群的患者5年生存率分彆低于無術後殘留、非高風險人群患者,差異均有統計學意義(P＜0.05); Cox迴歸模型錶明,高風險人群相對危險度[(RR)=22.461,P=0.038]、複髮轉移(RR=65.547,P=0.000)是影響髓母細胞瘤預後的獨立危險因素. 結論 髓母細胞瘤的治療首選手術切除+術後放射治療.屬于高風險人群、有複髮轉移的髓母細胞瘤患者預後較差.
목적 비교수술연합방료여방화료대수모세포류환자생존솔적영향,분석영향기예후적상관인소. 방법 회고성분석남방의과대학남방의원자2002년6월지2014년1월수치적79례수모세포류환자적림상자료,비교술후방화료여술후단순방료대수모세포류환자5년생존솔、무류생존솔적영향,Cox회귀모형분석영향수모세포류환자예후적상관인소. 결과 본조환자중74례행종류전절술,5례행차전절술;술후단순방료41례,술후방화료38례.술후단독방료여술후방화료환자적5년생존솔(73.2％vs 81.6％)、무류생존솔(65.9％vs 76.3％)비교차이균무통계학의의(P＜0.05).유술후종류잔류화복발전이、시고풍험인군적환자5년생존솔분별저우무술후잔류、비고풍험인군환자,차이균유통계학의의(P＜0.05); Cox회귀모형표명,고풍험인군상대위험도[(RR)=22.461,P=0.038]、복발전이(RR=65.547,P=0.000)시영향수모세포류예후적독립위험인소. 결론 수모세포류적치료수선수술절제+술후방사치료.속우고풍험인군、유복발전이적수모세포류환자예후교차.
Objective To compare the survival benefit of surgery combined with radiotherapy or surgery combined with radiotherapy plus chemotherapy for medulloblastoma patients,to analyze the related prognostic factors.Methods The clinical data of 79 patients with medulloblastoma,admitted to our hospital from June 2002 to January 2014,were retrospectively analyzed; the 5-year overall survival and event-free survival of patients accepted surgery combined with radiotherapy or surgery combined with radiotherapy plus chemotherapy were compared; Cox regression model was used to analyze the related prognostic factors.Results Totally,74 patients accepted total removal and 5 subtotal removal;after the surgery,radiotherapy only was performed in 41 patients and radiotherapy plus chemotherapy in 38.The overall survival (73.2％ vs.81.6％) and event-free survival (65.9％ vs.76.3％) showed no significant differences between patients receiving radiotherapy and patients receiving radiotherapy plus chemotherapy after surgery (P＞0.05).The 5-year overall survival in patients with residual tumor or recurrence and patients classified as high risk population was significantly lower than that in patients without residual tumor or recurrence and patients not classified as high risk population (P＜0.05); The Cox regression analysis showed that the high risk population (RR=22.461,P=0.038) and recurrence/metastasis (RR=65.547,P=0.000) are independent risk factors influencing the prognosis of medulloblastoma.Conclusions Surgical resection plus postsurgical radiotherapy acts as the first choice for treatment of medulloblastoma.Patients classified as high risk population and patients with recurrence/metastasis have poor prognosis.
