颅内转移瘤的术后评价及其预后分析

发布时间：2018-04-20 21:19

本文选题：脑转移瘤 + 手术治疗　；参考：《广西医科大学》2016年硕士论文

【摘要】：目的:回顾性分析颅内转移瘤患者术后的临床资料,探讨其手术治疗的临床疗效,分析影响颅内转移瘤患者术后生存的预后因素,以期为临床正确地评价脑转移瘤的预后及制定合理的治疗方案提供帮助。方法:收集2010年6月至2015年6月广西医科大学附属肿瘤医院手术治疗的47例颅内转移瘤患者的临床资料,通过电话的方式随访,采用Kaplan-Meier法进行生存分析,并对可能影响其预后的相关数据(年龄、性别、KPS评分、脑转移瘤数目、脑转移瘤大小、是否合并颅外转移、肿瘤标志物水平、脑转移瘤治疗方案)进行单因素Log-Rank检验分析及多因素Cox风险比例模型统计分析。结果:47例中39例患者术前有神经系统症状及体征,其中术后神经症状及体征消失30例,明显缓解8例,无缓解1例,临床神经症状缓解率为97.44%(38/39),无神经症状加重或手术死亡。47例脑转移瘤患者的中位生存时间为11个月,半年、1年、2年、3年的生存率分别为83%、46%、20%和4%。单因素分析提示是否合并颅外转移、脑转移瘤数目及治疗方案是影响生存时间的因素。多因素分析结果显示脑转移瘤数目、治疗方案为影响生存时间的独立因素。结论:1、手术可以解除颅内转移瘤患者危及生命的颅内高压症状,缓解颅神经症状,提高患者生存质量,为后续综合治疗创造有利条件;2、手术联合术后放化疗的综合治疗有助于延长颅内转移瘤患者的生存时间;3、本研究为回顾性资料,病例数少,更为可靠而确切的结果尚有待今后大样本、多中心随机对照实验加以验证。
[Abstract]:Objective: to retrospectively analyze the clinical data of patients with intracranial metastases after operation, to explore the clinical effect of surgical treatment, and to analyze the prognostic factors affecting the survival of patients with intracranial metastases. The aim of this study is to evaluate the prognosis of brain metastases and to make a reasonable treatment plan. Methods: the clinical data of 47 patients with intracranial metastases were collected from June 2010 to June 2015 in the Cancer Hospital affiliated to Guangxi Medical University. The patients were followed up by telephone and analyzed by Kaplan-Meier method. The relevant data (age, gender, KPS score, number of brain metastases, size of brain metastases, extracranial metastasis, tumor marker level) were analyzed. Single factor Log-Rank test and multivariate Cox risk ratio model were used. Results of 47 cases, 39 cases had neurological symptoms and signs before operation, including 30 cases of disappearance of postoperative neurological symptoms and signs, 8 cases of obvious remission, and 1 case of no remission. The remission rate of clinical neurological symptoms was 97.44 / 39. The median survival time of 47 patients with brain metastases was 11 months, 6 months, 1 year, 2 years and 3 years. The survival rates were 834620% and 4%, respectively. Univariate analysis showed that the number of brain metastases and the treatment plan were the factors affecting survival time. Multivariate analysis showed that the number of brain metastases and the treatment regimen were independent factors affecting survival time. Conclusion the operation can relieve the life-threatening symptoms of intracranial hypertension in patients with intracranial metastases, relieve the symptoms of cranial nerves, and improve the quality of life of patients with intracranial metastases. In order to create favorable conditions for the follow-up comprehensive therapy, the combined operation combined with postoperative radiotherapy and chemotherapy can prolong the survival time of patients with intracranial metastases. This study is a retrospective study, and the number of cases is small. The more reliable and accurate results need to be verified by a large sample in the future.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R739.41

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