目的：探讨脑间变性星型细胞瘤术后调强放疗并同步替莫唑胺化疗的临床疗效及影响预后的相关因素。方法：对25例术后经病理确诊的脑间变性星型细胞瘤患者进行回顾性分析，所有患者均进行调强放疗并同步整合加量技术，并同步口服替莫唑胺进行化疗，随访2年期总生存率，对影响脑间变性星型细胞瘤术后预后的独立因素进行评估。结果：本研究中位随访时间为41．8个月，所有患者中位生存时间12．4个月，1年、2年总生存率分别为67．9％、58．5％；未观察到与治疗相关的死亡，血液学毒性主要表现血小板、白细胞减少，不良反应为头痛、呕吐恶心，I ～ II 度骨髓抑制率为84．00％，III 度骨髓抑制率为16．00％，未发现 IV 度骨髓抑制；单因素分析显示：性别、手术切除情况、肿瘤位置等对脑间变性星型细胞瘤术后患者预后的影响无统计学意义（P＞0．05），年龄、WHO 分级、KPS 评分、术前化疗情况等因素对脑间变性星型细胞瘤术后患者预后影响有统计学意义（P＜0．05）；多因素分析结果显示：WHO 分级（P＝0．002）、KPS 评分（P ＝0．036）是影响脑间变性星型细胞瘤术后患者预后的独立因素。结论：脑间变性星型细胞瘤术后调强放疗并同步替莫唑胺化疗临床效果确切，WHO 病理分级和术前 KPS 评分是影响其预后的独立因素。%Objective :To investigate the brain degeneration of astrocytomas and postoperative IMRT for the same period of the clinical efficacy of temozolomide chemotherapy and related prognostic factors ,reference and basis for interventions .Methods :Treated by pathologically confirmed 25 cases of degenerative brain astrocytoma patients in this study ,the clinical data were retrospectively analyzed .All patients underwent IMRT and increase the amount of synchronous technology integration ,and the same period of oral temozolomide chemotherapy ,followed up for 2‐year overall survival ,and the influence of independent factors degeneration of brain cells after tumor star prognosis evaluation .Results :In this study follow‐up period ended in November 2014 ,with a median follow‐up time of 41 .8 months ,the median survival time for all patients 12 .4 months ,1 year ,2‐year overall survival rates were 67 .9% , 58 .5% ;not observed treatment‐related deaths ,mainly hematological toxicity of platelets ,leukopenia ,adverse reac‐tions were headache ,vomiting ,nausea ,I‐II myelosuppression was 84 .00% ,the degree of bone marrow suppression was 16 .00 percent III ,IV degree not found bone marrow suppression ;univariate analysis showed that the effects of gender ,surgery ,the tumor location transgender astrocytomas postoperative prognosis of patients was not statistical ‐ly significant between the brain ( P > 0 .05) ,age ,WHO classification ,KPS score ,preoperative factors such as chemotherapy circumstances statistically significant (P< 0 .05) influence degeneration astrocytomas prognosis among patients brain ;multivariate analysis showed that WHO classification (P= 0 .002) ,KPS score (P= 0 .036) affect the brain anaplastic astrocytomas independent factors of postoperative prognosis .Conclusion :degenerative brain astro‐cytomas postoperative IMRT and temozolomide chemotherapy earlier clinical exact effect ,WHO tumor grade and preoperative KPS score was an independent prognostic factor in its impact .
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