Strategies Of Treatment And Their Efficacy Analysis Of The Pineal Region Tumors

Objective: To explore different treatment strategies for pineal region tumors,analysis the general characteristics of the tumor of the region. The evaluating of theKPS function core before and after these treatment in patients with pineal region,and combined with statistical methods to evaluation of the effective of differentstrategies. Statistical analysis the pineal region tumors markers, to understand theirrole in the diagnosis and treatment of pineal region tumors.Materials and methods:68patients of pineal region tumors in Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology, withclinical and follow-up data were retrospectively collected, admitted on January1st2007to January1st2012. According to the different treatment strategies, divided intomicroscopic open surgery group (referred to as micro-surgery group) and shunting+(or) radioactive surgical treatment group (referred to as radioactive surgicaltreatment group). First, statistical analysis the symptom relief rate a week after withthe treatment and to compare the efficacy of the micro-surgery group and theradioactive surgical treatment group. Secondly, to make the two groups of patientswith preoperative, postoperative March KPS score, and analysis results werestatistically analyzed to evaluate the long-term efficacy of two treatment strategies.Statistics the serum tumor marker level value (including β-HCG and AFP) in patients before surgery, after surgery the same day, a week after surgery, aftersurgery in January, after surgery in March and after surgery more than six months,combined with clinical data to analysis the meaning and role of serum tumor markerschange in tumor diagnosis and treatment. In addition, summarized the generalcharacteristics of the pineal region tumors.Results: First, the computation of the two groups of patients with treatmentresponse rate. Secondly, the microsurgery group and radioactive surgical treatmentgroup two sets of preoperative and postoperative March KPS values of t test tocompare the two approaches on the quality of life with or without significant impact,and in the same way to analysis the KPS difference (ΔKPS,) the two groups aftersurgery in March. In addition, changes in patients with serum tumor marker levelstatistics, to draw different time periods of tumor markers in the water the averagecurve, and abnormal changes in the patients analyzed. The results showed that:microsurgery group and radioactive surgical treatment group on the pineal glandtumor treatment have a certain effect, can alleviate symptoms, improve quality oflife.A week after micro-surgery group44patients with postoperative symptoms of39cases of apparent ease,1patient died,4cases with varying degrees ofneurological dysfunction, the response rate was88.64%; radioactive surgicaltreatment of24patients within a week shunt through the pre-treatment or aftertreatment in20cases symptoms were alleviated, no patient who died,4cases ofpatients with symptoms no significant relief, including2cases further aggravate, theresponse rate was83.33%. However, long-term efficacy of efficacy of microsurgerygroup has a greater advantage, and can reduce the negative effect of radiotherapy. Inthe microsurgery group the postoperative March KPS significantly higher than thepreoperative statistical analysis t=-6.937(P=0.000<0.05, CI95%), having astatistically significant, indicating that the March after microscopic surgery toimprove patients’ clinical features, and improve the quality of life. In theradiosurgery group KPS values before and after treatment in March, we analyzedstatistically derived t-=-0.979(p=0.338>0.05, CI95%), the difference not have a statistically significant. Further two groups of patients with preoperative andpostoperative March the KPS difference (ΔKPS) for statistical analysis found that t=2.976(p=0.005<0.05.CI95%), the difference have a statistically significant,this result shows that long-term efficacy of radioactive surgical treatment of pinealregion tumors revealed poor microsurgical treatment, pending further study, andcan not significantly improve the quality of life of patients.The studying of theserum tumor markers in the pineal region tumor in the surgical group, we found13cases of elevated serum tumor marker levels in the microsurgery group of patients,including nine cases of mixed germ cell tumor patients, accounting for about70%.These patients by surgery and postoperative radiotherapy and chemotherapy, tumormarker levels were declining trend, and most returned to normal levels after January.Once the tumor marker levels was again unusual increase in majority of prompttumor recurrence, tumor with cerebrospinal fluid spread or distant metastases。Inour cases, one patient after the surgery and adjuvant therapy treatment, the β-HCGlevels remain is high, and eventually found chest metastasis.Conclusions: Micro-surgery and radioactive surgical treatment are the mosteffective treatment strategies of treating the pineal region tumor,all have areextremely effective, and the micro-surgery in the long-term efficacy and improvethe quality of life of micro-surgery have a greater advantage.The serum tumormarkers have a certain significance level of monitoring the treatment of pinealregion tumor after treatment closely monitor the level of value, and is conducive toevaluate the therapeutic effect, contribute to tumor recurrence or distant metastasis.