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1
題名:Prognostic Parameters in Malignant Gliomas     (26點)
惡性神經膠質瘤之預後參數
著者:Jo-Ting Tsai(蔡若婷) ;Yuen-Liang Lai(賴允亮) ;Chi-Yuan Yeh(葉啓源) ;Yu-Jen Chen(陳裕仁) ;Wen-Yi Shau(邵文逸) ;Chang-Hung Chung(鍾昌宏) ;Kou-Hwa Chang(張國華)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:退行性星狀細胞瘤 ; 多型性膠質母細胞瘤 ; 存活 ; 放射線治療 ; Anaplastic astrocytoma ; Glioblastoma multiforme ; Survival ; Radiotherapy
刊名:Therapeutic Radiology and Oncology
頁碼:49-61
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的: 本研究探討腦內惡性神經膠質瘤之病息, 其存在之特殊變異因子, 對於治療預後之影響。 材料與方法. 本研究共搜集了自民國7 4 年4 月至民國8 4 年4 月間, 於馬借紀念醫院, 經手術後診斷為腦內惡性神經膠瘤之4 2位病患。其中1 7位患有退行性星狀細胞瘤,另25位病人患有多型性膠質母細胞瘤。這些病患皆接受術後放射線治療。研究針對1 7項臨床因子及2項組織學因子,包括年齡、性別、出現頭痛、精神改變、輔相、視力改變、運動能力缺失、感覺改變、言語困難、術前行為狀態、開刀範圍、術後放射治療劑量、腦水腫、腦中腺移動、血腫形成、腫瘤部位、症狀持續時間、組織學分期及腫瘤腫形成, 分析這些因子對於存活期評估的重要性。 結果: 本研究分析之總中值存活期為1 8 . 7 月, 退行,性星狀細胞瘤病患之中值存活期為2 5 .4 月, 多型性膠質母細胞瘤病患之中值存活期為1 4 . 2月。分析結果利用C o x mult ivariate regression mode l 及Chisquaret e st 顯示, 組織分期、手術切除之範圓、年齡、性別及病患表現頭痛和連動機能缺失, 皆會影響治療之預後。 結論: 經由研究分析出惡性神經膠質瘤之預後參數, 可利用來作為病患之分組治療。針對不同預後因子,提供病患更合適之治療。
Aim: Despite recent advances in neuro-imaging , neurosurgical techniques, and aggressive approach using combined modalities, t he prognosis for patients with malignant gliomas remains dismal. The goal of this study was to increase our understanding of the relative influence that specific variable s have on the outcome of patients. Methods and Materials: Forty-two patients with intracranial mali gnant gliomas (17 with anaplastic astrocytomas and 25 with g lioblastoma multiforme), treated by surge ry and postoperative r adi otherapy at Mackay Memorial Hospital from Apr il 1985 through Apr il 1995, were ret rospecti vely reviewed. Twenty-six men and 16 women with a median age of 44 years (r ange, 10 to 70 yea rs ) were ente red in t he st udy. Seve nteen clinical factors (age at surgery; sex; initial presenting symptoms of headaches, ment al changes, seizure, visual changes, motor deficits, senso ry cha nges, a nd speec h difficulties; preoperative performance st a t us based on the Karnofsk y scale; the extent of surg ical remo val ; postoperative radiotherapy dose; t he presen ce of brain edema, brain midlin e shift , and hematoma formation; tumor sit e; duration of initial symptoms), and 2 histological fa ctors (hi stologi cal grade; tumor cystic formation) were analyzed to in vestigat e their importance in predicting length of survival. Data were analyzed usin g t he Cox proportional harzards analysis or Chi-squa re test. Results: The overall median survival time was 18.7 months. The median survival time was 25.4 months for anaplastic astrocytoma and 14.2 months for glioblastoma muItiforme. Four pr etreatment variables including histological grade, age, sex and the extent of tumor resection (subtotal or total) were found to have a s ta t ist ically sig nif icant effect on surv ival when analyzed together by t he Cox multivariate regression model. Univa r ia te analysis by the Chi-squa re t est identified the presen t ing neurological symptoms of mental changes and motor deficits as ha ving a n adve rse effect on survival. Conclusions: The aut hors conclude that hist ologi cal grade, age, sex, extent of tumor resection, and the presenting sympt oms of men tal cha nges or motor deficits were important prognostic parameters in malignant g liomas. By s t ra t ifying patients into more hom og en eous subg ro ups wit h fa vorabl e or unf'a vorable prognostic factors, t re atment can be specially tailore d for different subg roups.


    

本卷期目次
Therapeutic Radiology and Oncology
Prognostic Parameters in Malignant gliomas/ Jo-Ting TsaiYuen-Liang LaiChi-Yuan YehYu-Jen ChenWen-Yi ShauChang-Hung ChungKou-Hwa Chang
腦垂體腺瘤之放射線治療/ 戴于翔賴允亮鍾昌宏張國華陳裕仁邵文逸黃昭源
Combin Ation Radiotherapr and Chemotherapy for Organ Preserv Ation in Cancer Management/ Wing-Kai ChanKwan-Hwa ChiSang-Hue YenKuang Y. Chen
國立清華大學水池式反應器應用於硼中子捕捉治療的超熱中子束設計之現況/ 劉鴻嗚薛燕婉廖廷風朱惠珍開執中
Treatment Results of Laryngeal Cancer by Badiotherapy with or Without Surgery/ Louis Tak LuiSzu-Jung ChenLai-Lei TingPo-Ming WangNa-Na ChungChao-Yuan Huang
臺灣醫學物理現況與展望/ 黃英強
不同水流速度對假體內熱治療溫度分布之研究/ 熊佩韋許文林吳玉鈴蘇振隆施榕平
National Taiwan University Hospital Pilot Study of Chemoradiotherapy for Esophageal Carcinoma/ Louis Tak LuiChao-Yuan HuangLai-Lei TingPo-Ming WangNa-Na ChungSzu-Jung Chen
第二及第三期乳癌術後電子射線治療之結果/ 黃英彥梁雲王重榮陳惠君孫立民方富民
維生素C及Desmethylmisonidazole 對於CHO 細胞放射線效應之研究/ 許文林黃經民熊偑韋任益民盧昭元趙壯飛
Primary Malignant Fibrous Histiocytoma of The Breast a Case Report and Review of The Literature/ Wen-Haw SuMeng-Haw WuYuen-Liang LaiChang-Huang Chung
Combination Radiotherapy and Chemotherapy for Organ Preservation in Cancer Management/ Wing-Kai ChanKwan-Hwa ChiSang-Hue YenKuang Y. Chen
維生素C及Desmethylmisonidazole對於CHO細胞放射線效應之研究/ 許文林黃經民熊佩韋任益民盧昭元趙壯飛
Treatment Results of Laryngeal Cancer by Radiotherapy with or Without Surgery/ Louis Tak LuiSzu-Jung ChenLai-Lei TingPo-Ming WangNa-Na ChungChao-Yuan Huang
第二及第三期乳癌術後電子射線治療之結果/ 黃英彥梁雲王重榮陳惠君孫立民方富民
腦垂體腺瘤之放射線治療/ 戴于翔賴允亮鍾昌宏張國華陳裕仁邵文逸黃昭源
Prognostic Parameters in Malignant Gliomas/ Jo-Ting TsaiYuen-Liang LaiChi-Yuan YehYu-Jen ChenWen-Yi ShauChang-Hung ChungKou-Hwa Chang
National Taiwan University Hospital Pilot Study of Chemoradiotherapy for Esophageal Carcinoma/ Louis Tak LuiChao-Yuan HuangLai-Lei TingPo-Ming WangNa-Na ChungSzu-Jung Chen
不同水流速度對假體內熱治療溫度分布之研究/ 熊佩韋許文林吳玉鈴蘇振隆施榕平
國立清華大學水池式反應器應用於硼中子捕捉治療的超熱中子束設計之現況/ 劉鴻鳴薛燕婉廖廷風朱惠珍開執中
Primary Malignant Fibrous Histiocytoma of the Breast a Case Report and Review of the Literature/ Wen-Haw SuMeng-Haw WuYuen-Liang LaiChang-Hung Chung
學會專題研習 台灣醫學物理現況與展望/ 黃英強
 
   
 
   

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