摘要[目的]探讨MRI T2Flair切除范围和术后辅助化疗疗程对人脑胶质母细胞瘤(GBM)患者预后的影响.方法广东三九脑科医院神经外五科自2012年4月至2016年8月在唤醒麻醉、神经导航和神经电生理监测等技术下采用肿瘤切除术治疗GBM患者17例,现回顾性分析患者的临床资料和疗效,探讨MRI T2Flair切除范围和术后辅助化疗疗程对人脑GBM患者预后的影响.结果17例患者T1增强病灶均全部切除.患者中位生存时间20个月.T2Flair切除体积比0~10%、10%~25%、 大于25%组患者术后中位生存时间分别为19、22、24个月,3组患者的生存率比较差异无统计学意义(P>0.05).术后辅助化疗疗程<6次、≥6次组患者的中位生存时间分别为19、33个月,术后辅助化疗疗程<6次组患者的生存率低于术后辅助化疗疗程≥6次组,差异有统计学意义(P<0.05).结论T1增强病灶全切除时,T2Flair切除范围对GBM患者的预后无明显影响;而术后辅助化疗疗程≥6次的GBM患者的预后较好.

abstractsObjective To explore the impact of MR imaging T2 fluid-attenuated inversion-recovery sequence (MRI T2Flair) excision extension and postoperative chemotherapy in prognosis of patients with glioblastoma (GBM). Methods A retrospective study of clinical data and treatment efficacy of 17 patients with GBM, admitted to our hospital from April 2012 to August 2016, was performed. All patients were performed tumor resection by using awake anesthesia, neuroimage navigation, and intraoperative direct electrical stimulation. The impacts of the resection extent of T2Flair lesions and adjuvant chemotherapy on the prognosis of glioblastoma were analyzed. Results T1 enhanced lesions in these 17 patients were totally resected. The median follow-up duration was 18 months (8 months to 52 months). Median survival time was 20 months; the survival time of patients with resection ranges of 0%-10%, 10%-25% and more than 25% were 19, 22 and 24 months, respectively, without statistical differences (P>0.05). The patients adopted less than 6 courses chemotherapy had a 19-month-long median survival time, and those adopted 6 courses or more courses chemotherapy had a 33-month-long median survival time, with statistically significant difference (P<0.05). Conclusion When T1 enhanced lesions are totally resected, the resection extent of T2Flair lesions has no influence on patients survival time; however, patients accepted 6 or more courses of chemotherapy have a better survival.