两种放疗治疗恶性脑胶质瘤的近期疗效及远期预后影响因素分析

摘要/Abstract

摘要： 目的：对比两种放疗方案治疗恶性脑胶质瘤的近期疗效，探讨影响恶性脑胶质瘤患者远期预后的影响因素。方法：回顾性分析52例恶性脑胶质瘤患者的临床资料，其中30例接受三维适形放疗（3DCRT）治疗，22例接受调强放疗（IMRT）治疗，比较两组患者近期疗效、生活质量及远期预后情况，采用Logistic回归模型分析影响远期预后的危险因素。结果：精准放疗的总有效率75.00%，总疾病控制率94.23%，其中，3DCRT组的近期疗效有效率和疾病控制率分别为70.00%、96.67%，与IMRT组的81.82%、90.91%比较差异无统计学意义（P＞0.05）；治疗后两组患者的生活质量改善情况差异无统计学意义（60.00% vs 63.64%，P＞0.05）；至随访结束，52例恶性脑胶质瘤患者死亡19例，尚存活33例，生存率63.46%；Logistic回归分析结果显示，病理分级、术前癫痫发作、肿瘤切除程度是影响患者预后的独立危险因素，放疗前KPS评分、放疗等待时间是其保护因素（P＜0.05）。结论：3DCRT与IMRT治疗恶性脑胶质瘤的近期疗效相当；病理分级、放疗前癫痫发作、KPS评分、肿瘤切除程度、放疗等待时间对恶性脑胶质瘤患者化疗后远期预后的影响较大，临床应予以重视。

关键词: font-size:medium, ">精准放疗；恶性脑胶质瘤；近期疗效；远期预后；影响因素

Abstract: Objective：To compare the short-term efficacy of two radiotherapy regimens in the treatment of malignant glioma， and investigate the factors affecting the long-term prognosis of patients with malignant glioma. Methods： The clinical data of 52 patients with malignant glioma were retrospectively analyzed. 30 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 22 patients were treated with intensity-modulated radiotherapy (IMRT). The short-term efficacy， improvement of quality of life and long-term prognosis of the two groups were compared. Logistic regression model was performed to screen the risk factors affecting long-term prognosis. Results： The total effective rate of precision radiotherapy was 75.00%, and the total disease control rate was 94.23%. The short-term effective rate and the disease control rate in the 3DCRT group were 70.00% and 96.67%， respectively. Compared with 81.82% and 90.91% in the IMRT group, there was no significant difference(P>0.05). There was no significant difference in the improvement of quality of life between the two groups (60.00% vs 63.64%， P>0.05). By the end of follow-up, 19 of the 52 patients with malignant glioma died, 33 survived, with a survival rate of 63.46%. Logistic regression analysis showed that pathological grade, preoperative epileptic seizure and extent of tumor resection were independent risk factors influencing the prognosis, while KPS score before radiotherapy and wait time of radiotherapy were protective factors (P<0.05). Conclusion：3DCRT and IMRT have similar short-term efficacy in the treatment of malignant glioma. Pathological grade, epileptic seizure and KPS score before radiotherapy, extent of tumor resection and wait time of radiotherapy have greater influence on the long-term prognosis of patients with malignant glioma after radiotherapy, which deserves attention in clinical practice.

Key words: font-size:medium, ">Precision radiotherapy； Malignant glioma； Short-term curative effect； Long-term prognosis； Influencing factor

中图分类号:

孔河傈, 于贝贝. 两种放疗治疗恶性脑胶质瘤的近期疗效及远期预后影响因素分析[J]. 中国医药导刊, 2022, 24(11): 1099-1103.

KONG Heli, YU Beibei. Short-Term Efficacy of Two Kinds of Radiotherapy Regimens in the Treatment of Malignant Glioma and Influencing Factors of Long-Term Prognosis[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2022, 24(11): 1099-1103.

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