Preliminary Study Of Gamma Knife Radiosurgery On Individual Treatment Of Brain Glioma

Objective:To explore the role of the fusion technology of multi-modality image of different machines in outlining target volume in gamma knife radiosurgery of recurrent glioma; meanwhile analyze multi-factors during progress free survival of recurrent glioma to provide a platform with high technology for standard and individual treatment of glioma and accurate understanding of related effect after treatment.Methods:Selecting 68 patients with recurrent glioma in 2012-2015:consisting of 18 patients of WHO grade Ⅱ (26.4%),32 patients of grade Ⅲ(47.1%),18 patients of grade Ⅳ(26.5%) after primary surgery, of which 16 patients with diffuse astrocytoma (grade Ⅱ),30 patients with anaplastic astrocytoma (grade Ⅲ),18 patients with glioblastoma (grade Ⅳ),2 patients with oligodendroglioma (grade Ⅱ) and 2 patients with anaplastic oligodendroglioma (grade Ⅲ); conduct a double blind and randomized controlled experiment, respectively delineating biological target volume by the fusion technology of multi-modality image of different machines and MR ordinary and enhancement scan, one time follow-up every 1-3 month after operation as yet. The experiment uses statistical software SPSS 19.0 and Kaplan-Meier method to analyze and compute the survival rate and survival curve of experimental group and control group, do multiple-factor analysis of covariant by Cox proportional hazard model, set the difference of P<0.05 as of statistical significance to judge the advantage of fusion technology of multi-modality image of different machines in delineating biological target volume of recurrent glioma and the influence of multi-factor on progress free survival.Results:1.Single-factor analysis of survival rate and survival curve by Kaplan-Meier method:median estimates of progress free survival of experimental group and control group are 14 months and 10 months, statistics tests was conducted on two sets of data and the results (2=7.382, P<0.05; 2=3.943, P<0.05; 2=5.290, P<0.05) shows that the difference between two groups is of statistical significance and progress free survival of experimental group is longer than that of control group.2.Multi-factor analysis of Cox proportional hazard model:By introducing group category, tumor grade, additivity index (Ki-67), tumor volume, diagnosis time into Cox proportional hazard model, and obtained the P value of them are all< 0.05, the difference is of statistical significance. With respect to high risk factor of grade Ⅳ, Exp of grade Ⅱ and Ⅲ are 0.07 and 0.169. Besides, P value of diagnosis time are all>0.05 without statistical significance.Conclusion:1.Compared with traditional MRI, the fusion technology of multi-modality image of different machines do better in delineating biological target volume and could prolong progress free survival.2.Tumor grade, additivity index, and tumor volume have negative correlation with progress free survival. The higher tumor grade is, more influence on progress free survival.3.Diagnose time has little impact on progress free survival.4.Additivity index as one of risk factors should be paid special attention.