王重韧,赵明,徐欣,韩磊,尤宇,赵四军

• 1:郑州大学附属肿瘤医院神经外科

摘要(Abstract)：

目的探讨手术联合125I粒子植入治疗复发性脑胶质瘤的疗效及影响预后的主要因素。方法 60例手术加放化疗后复发的脑胶质瘤患者随机分为手术联合125I粒子植入组35例,单纯手术对照组25例进行治疗,术后每2个月复查MRI进行随访,收集临床资料和随访结果进行分析。用Kaplan-Meier法计算全组的累积生存率,Log-Rank检验做单因素分析,Cox比例风险回归模型进行多因素分析。结果全组随访32~128周,平均随访时间52.8周,125I粒子植入组中位生存期60.3周(95%CI,53.3~67.3周),1 a生存率为71.4%,单纯手术组中位生存期43.1周(95%CI,37.5~48.8周),1 a生存率为36%(P<0.05)1。25I粒子植入组中WHO病理分级Ⅱ、Ⅲ、Ⅳ期的患者1 a生存率分别为87.8%、65.3%、36.4%(P<0.01);肿瘤全切组和次全切的患者1 a生存率分别为79.2%和54.5%(P<0.05)。单因素分析显示,肿瘤组织学分级、肿瘤部位、肿瘤切除程度和放射性并发症是手术联合125I粒子植入治疗复发性胶质瘤的预后影响因素;多因素分析显示肿瘤组织学分级和肿瘤切除程度是影响预后的独立因素。结论手术联合125I粒子植入可有效地延缓脑胶质瘤的生存时间,提高患者的生存率,肿瘤组织学分级和肿瘤切除程度是影响其预后的最重要因素。

关键词(KeyWords)： 125I粒子;复发性脑胶质瘤;预后因素

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王重韧,赵明,徐欣,韩磊,尤宇,赵四军

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