摘要
目的通过分析胸腺瘤的长期生存结果，评价预后因素对胸腺瘤的影响，进而找出比较理想的治疗方法。方法回顾性分析天津医科大学附属肿瘤医院的142例胸腺瘤的临床资料。统计采用SPSS软件包，单变量分析用Kaplan-Meier法，用Cox回归模型进行多因素分析。结果142例患者5、10年生存率分别为59．9%、45．8%。Masaoka分期的各期5、10年生存率分别为Ⅰ期93．8%、79．2%，Ⅱ期79．3%、55．2%，Ⅲ期53．1%、34．4%，Ⅳ期0、0。伴重症肌无力者30例，其中全身型19例，眼肌型11例；5、10年生存率分别为83．3%、60．0%，有3例患者最终死于重症肌无力。不伴重症肌无力者112例，5、10年生存率分别为53．6%、42．0%。手术治疗116例，根治性切除84例，姑息性切除9例，仅取活检23例。放疗89例，术后放疗55例。单变量分析中Masaoka分期、是否伴有重症肌无力、病理组织学类型、治疗方式是预后生存指标，最终在多变量分析中得出Masaoka分期、是否伴有重症肌无力、治疗方式是预后生存指标。结论胸腺瘤诊断主要依靠临床及组织学判断，治疗原则应尽可能广泛切除肿瘤，术后根据具体情况辅以放疗、化疗。影响胸腺瘤长期生存最重要的因素为Masaoka临床分期、治疗方式。
Objective The aim of this study is to draft the judicious treatment methods by analyzing the Long-term survival result of thymoma and evaluating the effect that prognosis analysis has on thymoma. Methods Retrospective analysis of the chnical material of 142 patients with thymoma in the Tianjin Medical University Cancer Hospital from January 1954 to January 2001. Statistical analysis was performed using the SPSS software package. The Kaplan-Meier method was used single variable analysis, The Log-rank test was used to compare survival between groups, The Cox＇s proportional hazards model was used to multi-factor analysis. Results The 5- and 10-year survival rate of the 142 patients was 59.9% and 45.8%, respectively. Staging was adopted on the Masaoka＇s way, 5- and 10-year survival rates was ： 93.8% , 79.2% in stage Ⅰ ; 79.3%, 55.2% in stage Ⅱ ; 53.1% , 34.4% in stage Ⅲ ; and 0 and 0 in stage Ⅳ. Among 30 patients associated with myasthenia gravis, 19 patients suffered from generalized myasthenia gravis and 11 patients of ocular myasthenia gravis, with 5- and 10-year survival rate of 83.3% and 60.0%, respectively. Three patients finally died of myasthenia gravis. The 5- and 10-year survival rate of 112 patients without myasthenia gravis was 53.6% and 42.0%, respectively. Among 116 patients, treated with surgery, resection was carried out in 84 patients, palliative resection in 9 patients, and biopsy only in 23 patients. Eighty-nine patients were given radiotherapy and 55 patients had postoperative radiotherapy. Single variable analysis showed that Masaoka clinical staging, association with myasthenia gravis, histopathologic subtype and the method of treatment were prognostic factors. Finally, drawing the conclusion through muhivariable analysis; Masaoka clinical staging, association with myasthenia gravis and the treatment method were prognostic factors. Conclusions The diagnosis of thymoma is made clinically and pathologically. The treatment principle should be wide resection of the tumor. Radiotherapy and chemotherapy should be given according to the individual and findings special after the surgery. The most important determinants of Long-term survival in thymoma are Masaoka clinical staging and thoroughness of the resection.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2007年第2期113-117,共5页
Chinese Journal of Radiation Oncology
关键词
胸腺肿瘤
纵隔肿瘤
放射疗法
预后
Thymus neoplasms
Mediastinum neoplasma
Radiotherapy
Prognosis
