【摘要】 目的:探讨高级别胶质瘤的手术和术后放化疗的治疗效果。方法:回顾性分析56例高级别胶质瘤患者的临床资料，均采用手术、术后同步放化疗及6个周期以上的替莫唑胺化疗，对其治疗效果和不良反应进行评价分析。结果:56例患者手术全切除10例(17.9%),次全切除35例(62.5%),部分切除11例(19.6%)。分子病理提示IDH1132H突变19例；MGMT基因启动子甲基化20例。随访过程中13例未见明显复发；35例复发；1例出现脊髓的多发转移灶；7例出现放射性脑损伤，其中3例再次手术减压，4例保守治疗。12个月、24个月和36个月总生存率分别为66.1%、50.0%和32.1%;无进展生存率分别为57.1%、 39.3%和25.0%。结论:高级别胶质瘤预后不佳，术后残留、复发、转移和放射性损伤是治疗的重点和难点；MGMT基因启动子甲基化患者总体生存率和无进展生存率高于MGMT启动子未甲基化患者。更多还原

【Abstract】 Objective:To explore the effect of operation and postoperative radiotherapy and chemotherapy for high grade glioma.Methods:The clinical data of 56 patients with high grade gliomas were analyzed retrospectively.All patients were treated with operation, postoperative concurrent radiotherapy and more than 6 cycles of Temozolomide chemotherapy.Results:Total resection was performed in 10 cases(17.9%),subtotal resection in 35 cases(62.5%) and partial resection in 11 cases(19.6%).Molecular pathology showed IDH1132H mutation in 19 cases and MGMT gene promoter methylation in 20 cases.During the follow-up, there were 13 cases without obvious relapse, 35 cases with recurrence, 1 case with multiple metastasis of spinal cord, 7 cases with radiation brain injury, 3 cases with reoperation decompression and 4 cases with conservative treatment.The overall survival rates of 12 months, 24 months and 36 months were 66.1%,50.0% and 32.1%,and the progression free survival rates were 57.1%,39.3% and 25.0%.Conclusion:The prognosis of high-grade gliomas is poor, and postoperative residual, recurrence, metastasis and radiation injury are the key and difficult points of treatment.The overall survival rate and progression free survival rate of patients with MGMT promoter methylation were higher than those of patients with MGMT promoter unmethylation.更多还原