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目的:回顾性分析低分级脑胶质瘤(LGG)术后患者放疗的3年生存率及其影响因素。方法:回顾性分析放射治疗的101例LGG术后患者,其中肉眼全切的患者44例、次全切除的57例,60例患者联合化疗,手术至开始放疗的中位时间为24 d,放疗剂量为40～60 Gy。K-M法进行生存率的计算,Log-rank进行单因素分析,用Cox回归行多因素分析。结果:1、3年生存率分别为91%和70%。单因素分析显示,放疗前KPS评分(P=0.01)、肿瘤大小(P=0.002)、手术切除程度(P<0.000)、放疗总剂量(P=0.008)、年龄(P<0.000)及是否联合化疗(P=0.007)是影响LGG术后放疗3年生存率的重要因素。多因素分析显示,放疗前KPS评分(P=0.034)、手术切除程度(P=0.001)、放疗剂量(P=0.013)、年龄(P<0.000)是影响LGG术后放疗3年生存率的独立因素。手术切除方式对其3年生存率的影响大于放疗剂量的影响,P<0.05。结论:年龄<40岁、放疗前KPS评分≥70、肉眼全切及放射治疗剂量54～60 Gy是较好的相关影响因素。
Objective: To retrospectively analyze the 3-year survival rate of radiotherapy and its influencing factors in patients with low grade gliomas (LGG). Methods: A total of 101 LGG patients undergoing radiotherapy were retrospectively analyzed. Forty-four patients undergone total macroscopic resection, 57 patients underwent total resection and 60 patients underwent combined chemotherapy. The median time between the initiation of radiotherapy and surgery was 24 days. Radiotherapy The dose is 40-60 Gy. K-M method to calculate the survival rate, Log-rank univariate analysis, Cox regression multivariate analysis. Results: The 1- and 3-year survival rates were 91% and 70% respectively. Univariate analysis showed that KPS score (P = 0.01), tumor size (P = 0.002), degree of resection (P <0.000), total radiotherapy dose (P = 0.008), age Chemotherapy (P = 0.007) was an important factor affecting the 3-year survival rate of LGG after radiotherapy. Multivariate analysis showed that KPS before radiotherapy (P = 0.034), degree of surgical resection (P = 0.001), radiotherapy dose (P = 0.013) and age (P <0.000) were the independent 3-year survival rates factor. The effect of surgical resection on 3-year survival rate was greater than that of radiotherapy dose, P <0.05. CONCLUSIONS: Age <40 years, KPS score ≥70 before radiotherapy, total macroscopic resection and radiotherapy dose of 54-60 Gy are better related factors.