摘要
目的 探讨原发性脊髓胶质母细胞瘤的临床特点及其预后影响因素.方法 回顾性纳入2008年1月至2015年12月四川大学华西医院神经外科行手术治疗的14例原发性脊髓胶质母细胞瘤患者,总结其临床特征并分析影响患者预后的因素.结果 14例患者中,近全切除4例,部分切除5例,活检5例.9例术后接受放、化疗,3例仅行化疗,2例未行放、化疗.中位随访时间为15个月（5-26个月）,1年和2年生存率分别为79％ （11/14）和7％（1/14）.中位总生存期（OS）为15个月,中位无进展生存期（PFS）为8个月.单因素Log-rank分析显示,年龄以及是否进行术后放疗均为OS和PFS的影响因素（均P〈0.05）;术前Karnofsky功能状态评分（KPS）为OS的影响因素（P=0.033）,但并非PFS的影响因素（P=0.106）;性别、肿瘤切除程度以及病理学结果均非OS及PFS的影响因素（均P〉0.05）.单因素Cox回归分析显示,年龄、术后是否放疗均影响OS和PFS（均P〈0.05）;而术前KPS仅影响OS（P=0.046）.多因素Cox逐步回归分析显示,术后是否放疗为影响OS和PFS的惟一因素（均P 〈0.05）,放疗者较未放疗者的生存期长.结论 原发性脊髓胶质母细胞瘤临床罕见且预后极差.肿瘤切除程度与患者的预后无关,术后联合放疗能在一定程度上延长患者的生存期.
Objective To discuss the clinical characteristics and prognostic factors of primary spinal cord glioblastomas.Methods A total of 14 patients with primary spinal cord glioblastomas who underwent surgical treatment from January 2008 to December 2015 at Department of Neurosurgery,West China Hospital,Sichuan University were retrospectively analyzed.The clinical features were summarized and influencing factors of outcomes were investigated.Results Among the 14 patients,4 received gross total resection,5 received partial resection,and biopsy was conducted in 5 cases.Nine cases received postoperative radiotherapy and chemotherapy,3 received chemotherapy only,and 2 did not undergo radiotherapy or chemotherapy.The median follow-up period was 15 months （range：5-26 months）,and the 1-and 2-year survival rates were 79% （11/14） and 7% （1/14）,respectively.The median overall survival （OS） was 15 months,and the median progression free survival （PFS） was 8 months.Log-rank univariate analysis showed that age and postoperative radiotherapy were influencing factors for OS and PFS （all P 〈 0.05）.Preoperative Karnofsky performance scale （KPS） was the influencing factor of OS （P =0.033） rather than PFS （P =0.106）.The OS and PFS had no correlation with gender,tumor resection degree or pathological results （all P 〉 0.05）.Univariate Cox regression analysis showed that age and postoperative radiotherapy affected the OS and PFS of the patients （all P 〈 0.05）,while preoperative KPS score only affected OS （P =0.046）.Multivariate Cox stepwise regression analysis showed that postoperative radiotherapy was the only factor affecting OS and PFS （all P 〈 0.05） and the survival time in the radiotherapy group was longer than that in the non-radiotherapy group.Conclusions Primary spinal cord glioblastoma is rare and its prognosis seems poor.The extent of tumor resection has no correlation with the outcome.Postoperative radiotherapy could prolong the survival of patients to certain extent.
出处
《中华神经外科杂志》
CSCD
北大核心
2018年第2期154-158,共5页
Chinese Journal of Neurosurgery
关键词
胶质母细胞瘤
脊髓
治疗
预后
Glioblastoma
Spinal cord
Therapy
Prognosis
