脑胶质瘤术后调强放疗预后分析

发布时间：2018-05-30 19:13

  本文选题：脑胶质瘤 + 调强放射治疗　； 参考：《福建医科大学》2014年硕士论文

【摘要】：【目的】 分析脑胶质瘤术后调强放疗患者生存情况，并探讨影响脑胶质瘤患者的相关预后因素。 【方法】 回顾性分析2009年10月-2013年6月福建医科大学附属第一医院放疗科初次接受调强放射治疗的脑胶质瘤术后患者。收集患者的年龄、性别、病理类型、肿瘤病理分级、是否同步放化疗、肿瘤部位、肿瘤最大直径、术前是否有癫痫、放疗剂量、GFAP、Olig2、O6-甲基鸟嘌呤-DNA-甲基转移酶（O6-methylguanine-DNA-methyltransferase,MGMT）的表达、Ki67水平的表达以及生存时间等资料。观察所有患者1年、2年及3年的总生存率。采用Kaplan-Meier法计算生存率，Log-rank检测比较各组间生存率的差别；采用Cox比例风险模型进行预后相关因素的研究。 【结果】 共有87例患者符合要求，其中随访到84例，随访率为96.5%（84/87），随访时间1-48个月，，中位随访时间14个月。全组患者中位生存时间36个月，共24例复发及23例死亡，1年、2年及3年总生存率分别为84.8%、67.5%和48.4%。单因素分析显示年龄42岁组生存期优于年龄≥42岁组（P=0.026）；无癫痫组生存期优于有癫痫组（P=0.018）；Ki67＜10%组生存期优于Ki67≥10%组(P=0.015)。病理级别越高生存期越短（P0.001）；Cox多因素分析显示病理级别是影响患者生存期的独立因素（P0.001）。 【结论】 病理级别是影响患者生存期的独立因素，病理级别越高，预后越差。
[Abstract]:[purpose] To analyze the survival of patients with glioma treated by IMRT, and to explore the prognostic factors of glioma patients. [methods] From October 2009 to June 2013, the patients with glioma were treated with IMRT for the first time in the Department of radiotherapy, the first affiliated Hospital of Fujian Medical University. Age, sex, pathological type, pathological grade, concurrent radiotherapy and chemotherapy, tumor location, maximum diameter of tumor, epilepsy before operation were collected. Expression of O6-methylguanine-DNA-methyltransferase (MGMTT) and the expression of Ki67 and survival time of O6-methylguanine-DNA-methyltransferase (MGMTT) in patients with Olig2Olig2O6-methylguanine-DNA-methyltransferase. The 1 -, 2-and 3-year overall survival rates of all patients were observed. Kaplan-Meier method was used to calculate the survival rate and Log-rank test was used to compare the difference of survival rate among the groups, and Cox proportional risk model was used to study the prognostic factors. [results] A total of 87 patients met the requirements, of which 84 were followed up, with a follow-up rate of 96.50.84 / 87, with a follow-up time of 1-48 months and a median follow-up time of 14 months. The median survival time was 36 months. The overall survival rate of 1 year, 2 year and 3 years was 84.8% and 48.4%, respectively. Univariate analysis showed that the survival time of 42 years old group was better than that of Ki67 鈮

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