| Background: Medulloblastoma(MB),a malignant tumor of the posterior cranial fossa,is extremely malignant and easily spreads through the cerebrospinal fluid to the entire central nervous system.In 2007,the World Health Organization(WHO)defined WHO grade IV in classification criteria for central nervous system tumors.Even after comprehensive treatment with surgery,radiotherapy and chemotherapy,the prognosis of the patients is still not ideal.Although surgical resection is the main method of resection for patients with MB,the extent of resection varies from clinical center to clinical laboratory.Even under such circumstances,many clinical studies have demonstrated that systemic radiotherapy and chemotherapy after surgery can significantly improve patients.Prognosis.However,excessive chemoradiotherapy damages children's auditory,cognitive,and endocrine systems,and causes many complications such as growth and development disorders,mental decline,and cognitive impairment.Currently,medulloblastoma treatment strategies include surgical removal of the tumor,postoperative adjuvant total spinal cord radiotherapy,and selective chemotherapy.However,as medulloblastomas are rare,as of now,the number of cases studied in most single-center clinical studies has been relatively small,and the results of the relevant factors for the retrospective analysis of medulloblastomas in the previous literature have varied,and After the current single-center clinical trial,the postoperative radiotherapy and chemotherapy-related data were all different.Therefore,the current clinical lack of effective criteria or reference to assess the prognosis of patients with MB,while the lack of a relatively individualized adjuvant treatment program,which caused many patients undertreatment or excessive,not only a huge economic burden on the family of patients,the former even It may result in incomplete or even relapse of the patient's treatment.The latter may cause huge postoperative side effects and sequelae of the patient.The traditional program to determine the prognosis of the patient's condition is often based on factors such as age,location of the tumor,whether it is transferred,and what is seen during the operation.It is undeniable that many of them are adulterated by subjective components.Therefore,the clinical factors and prognosis of medulloblastoma are studied to find out a meaningful index,which is very necessary for the progressive one-stage treatment and evaluation of the prognosis of patients.Objective: The clinical factors and prognosis of medulloblastoma were studied to find out a meaningful index.The purpose was to summarize the clinical features of MB patients,discuss the effects of various treatment methods on prognosis,and also to perform various clinical relevant factors.Univariate and multivariate survival prognostic analyses provide convenience to clinicians.Methods: This part of the study retrospectively studied the cases of patients with medulloblastoma who had archived the medical records of the First Hospital of Jilin University from 2000 to 2015.The data were entered into the Excel spreadsheet one by one(Microsoft Office 2010)Use IMB SPSS Statistics 20 software for statistical analysis.The factors such as age,sex,tumor location,degree of surgical resection,history of complain time,pathological type,hydrocephalus and brain stem adhesion were analyzed as univariate analysis.Kaplan-Meier(K-M)method and Log-Rank method were used for survival analysis to compare the differences between groups.The two-sided test was statistically significant when P was greater than 0.05.Finally,COX regression multivariate model analysis to study the impact of many factors on the prognosis and determine the final influencing factors.Results: Forty-one patients were enrolled in this study.Thirty children were infants and 11 were adults.The ratio of male to female was 21:20.The dominant type was central(25/41).The histopathological types were mainly classic(17/41).There was no significant difference in tumor location and histopathological types between children and adults.The mean survival time of children group was longer than that of adult group,with no significant difference between the two groups.Gender(male vs female),degree of tumor resection(total resection vs.subtotal cut),and age(adult vs children)did not show statistically significant differences in survival time.Tumor location(central vs.peripheral),histopathological classification(large cell / anaplastic and classical)chief complaint history of time,is associated with preoperative hydrocephalus,brain stem tumor whether adhesions after surgery if the discharge line There was a significant difference in the survival time of chemotherapy.Tumor location(central vs.peripheral),histopathological type(Large cell / Metaplastic and Classic),time of complaint,preoperative with hydrocephalus,tumor and brain stem adhesion,postoperative chemoradiotherapy and other factors.There are significant differences in the survival time according to the Kaplan-Meier(K-M)method.Conclusion: The time history of the chief complaint,the presence or absence of hydrocephalus preoperatively,the adhesion between the tumor and the brain stem,and radiotherapy and chemotherapy after surgery.There were significant differences in the survival time after radiotherapy and chemotherapy. |
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