Clinical observation on the impact of different treatment regimens on the prognosis of patients with glioma
ZHAO Nan
ZHANG Manze
LI Zhaoxia
ZHAO Wei
WANG Yunmei
Abstract：Objective To explore the efficacy of surgery,radiotherapy[three-dimensional conformal radiotherapy(3D-CRT)/fractionated stereotactic radiotherapy(FSRT)]and chemotherapy[temozolomide(TMZ)/nimostine(ACNU)]in the treatment of primary and recurrent gliomas.Methods A retrospective analysis was conducted on the clinical medical records of 78 patients with glioma admitted to the Rocket Force Specialized Medical Center from June 2017 to April 2023.Results The median age of all patients in the group was 50 years old(ranging from 13 to 76 years old),and there were 39 male patients.At the initial treatment,69 cases underwent surgical resection,21 cases received FSRT,and 47 cases received 3D-CRT.Thirteen cases received ACNU monotherapy chemotherapy,and 38 cases received TMZ chemotherapy.Multivariate analysis showed that radiotherapy at the initial treatment(HR=0.325,95%CI:0.118-0.816,P=0.018)and chemotherapy(HR=0.516,95%CI:0.284-0.968,P=0.039)can reduce the risk of recurrence.Among them,3D-CRT is superior to FSRT,and TMZ is superior to ACNU.Among the 39 relapsed patients,neither radiotherapy(P=0.480)nor chemotherapy(P=0.830)after relapse could reduce the risk of secondary relapse.Although surgery showed a reducing trend,it did not reach a significant difference(HR=0.296,95%CI:0.075-1.171,P=0.083).In terms of overall survival,surgery could reduce the risk of death(HR=0.246,95%CI:0.063-0.829,P=0.025),while radiotherapy(P=0.142)and chemotherapy(P=0.539)had no significant effect.Conclusion Adjuvant chemoradiotherapy can reduce the recurrence risk of primary glioma.Among them,the efficacy of 3D-CRT is superior to that of FSRT,and TMZ is superior to ACNU.Surgery may help reduce the risk of secondary progression after recurrence and significantly improve overall survival.In addition,3D-CRT and multi-cycle chemotherapy can prolong the overall survival time of patients with WHO grade IV glioma.
Keywords：GliomaSurgeryRadiotherapyChemotherapy
Publication Date：2025-09-28
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：6( 893-898 )