| 杨寅寅,徐睿哲,杨海玲,等.儿童颅内室管膜瘤辅助放疗患者的生存及生活质量分析[J].中华放射医学与防护杂志,2026,46(2):192-197.Yang Yinyin,Xu Ruizhe,Yang Hailing,et al.Survival and quality of life of pediatric patients with intracranial ependymoma undergoing postoperative adjuvant radiotherapy[J].Chin J Radiol Med Prot,2026,46(2):192-197 |
| 儿童颅内室管膜瘤辅助放疗患者的生存及生活质量分析 |
| Survival and quality of life of pediatric patients with intracranial ependymoma undergoing postoperative adjuvant radiotherapy |
| 投稿时间：2025-01-23 |
| DOI：10.3760/cma.j.cn112271-20250123-00033 |
| 中文关键词: 室管膜瘤 放射治疗 生存 生活质量 |
| 英文关键词:Ependymoma Radiotherapy Survival Quality of life (QoL) |
| 基金项目:江苏省卫生健康委员会科研项目(JSDW202236);苏州市科技计划(医疗卫生科技创新)项目(SKY2022167) |
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| 中文摘要: |
| 目的 探讨颅内室管膜瘤(EPEN)患儿术后放疗生存状态及预后的因素,并分析其生活质量。方法 回顾性分析2012年11月至2023年11月在苏州大学附属第二医院放疗科收治的29例EPEN患儿的临床资料。采用Kaplan-Meier法分析患儿5年总生存(OS)及无进展生存(PFS),并通过log-rank检验分析影响OS及PFS的因素。存活患儿的生活质量通过生长发育状态、日常生活活动能力以及社会角色担当3个方面评估。结果 29例患儿的5年OS及PFS分别为84.5%和60.2%。11/29例患儿在放疗后复发,中位OS为56个月(18~120个月)。单因素分析结果提示,年龄＜3岁、肿瘤非全切,以及Ki-67指数≥20%是PFS的危险因素(χ2=4.89、8.44、5.13,P<0.05)。8例患儿轻度消瘦,2例超重,其余15例的体质量指数(BMI)在正常范围内。20例患儿的WeeFIM量表总得分为126分;4例超过108分;1例为49分。有6例患儿休学1~3年,2例在学校适应困难,共有12例患儿成绩中等或较差,但交流无障碍。结论 儿童EPEN术后放疗能取得较好的OS,但复发率仍处于较高水平。年龄、手术切除程度以及Ki-67的表达是影响PFS的重要因素。对于存活EPEN患儿,大多数生活质量尚可,在未来应当得到更多的关注。 |
| 英文摘要: |
| Objective To explore the survival status and prognostic factors of pediatric patients with intracranial ependymoma (EPEN) following postoperative radiotherapy and analyze their quality of life (QoL). Methods A retrospective analysis was conducted on the clinical data of 29 EPEN children who were treated in the Department of Radiotherapy and Oncology of the Second Affiliated Hospital of Soochow University from November 2012 to November 2023. Their 5-year overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and the factors affecting their OS and PFS were assessed through the log-rank test. The QoL of the surviving patients was evaluated from three aspects: growth and development conditions, the ability to perform activities of daily living (ADL), and social role assuming. Results The 29 EPEN patients exhibited a 5-year OS and PFS of 84.5% and 60.2%, respectively. Among these, 11 patients suffered from recurrence following radiotherapy, with a median OS of 56 months (range: 18-120 months). Univariate analysis identified several risk factors affecting the PFS, including an age of less than three years, incomplete tumor resection, and a Ki-67 index of 20% or higher (χ2=4.89, 8.44, 5.13, P<0.05). Additionally, body mass index (BMI) assessment was performed among the 25 survivors, revealing that eight were moderately underweight, two were overweight, and the remaining 15 had a normal BMI. The ADL assessment using the Wee functional independence measure (WeeFIM) indicated that 20 patients received a total WeeFIM score of 126 each, four patients scored over 108, and one received a total WeeFIM score of 49. For social role assuming, six patients experienced school suspensions for 1-3 years, while two patients faced challenges in adjusting to school. In contrast, despite average or poor academic performance, a total of 12 patients did not suffer from any communication barriers. Conclusions For pediatric patients with EPEN, postoperative radiotherapy achieves relatively high OS; however, the recurrence rate remains high. Factors affecting their PFS include age, the extent of surgical resection, and the Ki-67 expression. Most of the EPEN survivors have acceptable QoL, which warrants increasing attention in the future. |
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