中文摘要：

目的分析原始神经外胚层肿瘤（PNET）术后复发患者的预后影响因素。方法回顾性分析我院2008年6月-2014年12月收治的30例接受手术后肿瘤复发的PNET患者,其中单纯手术者2例,手术＋化疗者15例,手术＋放疗者3例,手术＋化疗＋放疗者10例。采用Kaplan-Meier法绘制PNET术后复发患者生存曲线,并行单因素分析性别、年龄、手术切除完整性、治疗模式及无复发间期（RFI）对总生存（OS）和复发后生存（RFS）的影响,采用Log-rank法检验其差异显著性,Cox回归模型对上述因素进行分析。同时对近20年国内外PNET相关文献进行复习和总结。结果全组中位总生存期为30个月;1、3、5年生存率分别为80.0%、44.1%、20.7%。26例出现术后局部复发（86.7%）,4例出现术后远处转移（13.3%）。全组中位RFI为4个月,6个月、1年和2年RFI分别为33.3%、16.7%、6.7%。全组中位复发后生存时间为14个月,1、3、5年复发后生存率分别为60.7%、16.9%、8.4%。单因素分析结果显示,放疗及手术切除完整可延长PNET术后复发患者的总生存（P值分别为0.006和0.033）,RFI≥6个月患者的预后优于RFI〈6个月的患者预后（P=0.001）。多因素分析结果显示：放疗和RFI≥6个月是PNET术后复发患者长期生存的独立影响因素（P值分别为0.047和0.012）。从2000年至今,报道PNET复发的文献患者共计1608例,在不同复发模式中,局部复发占292例,远处转移1089例,同时发生局部复发和远处转移227例。中位RFI 0.1~128个月,5年PRS 13%~28%,影响复发后生存（PRS）的因素包括：RFI≥24个月、初诊是否发生转移、大剂量化疗及局部放疗。结论 PNET术后复发患者预后极差,放疗在改善PNET术后复发患者总生存具有重要意义。术后6个月内发生复发严重影响PNET患者的总生存,但对复发后生存的影响没有统计学意义。

英文摘要：

Objective To analyze the prognostic factors of primitive neuroectodermal tumor（PNET） for postoperative recurrent patients.Methods Thirty patients admitted from Jun.2008 to Dec.2014 and diagnosed as PNET were retrospectively analyzed.Postoperative recurrence happened in all of the patients,of whom 2 received surger y alone,15 received surger y and chemotherapy without radiotherapy,3 received surger y and radiotherapy without chemotherapy,and 10 received surger y,radiotherapy and chemotherapy.Kaplan and Meier method was employed to draw the sur vival cur ve of the postoperative recurrent PNET patients,and to evaluate the effects of sex,age,radical resection,therapeutic method and relapse-free interval（RFI） on the overall survival（OS）.Log-rank method was used to test the significance of differences,and Cox regression was used to analyze all the factors listed above.The literatures related to PNET published domestically and abroad in recent 20 years were reviewed.Results The overall median survival time was 30 months.The OS rates of 1,3 and 5 years were 80.0%,44.1% and 20.7%.Local recurrence happened in 26 patients（86.7%）,and distant recurrence in 4 patients（13.3%）.The overall median RFI was 4 months,and the RFI rates of 6 months,1 year and 2 years were 33.3%,16.7% and 6.7%,respectively.The overall median recurrence-free survival（RFS） time was 14 months,and the PRS rates of 1,3 and 5 years were 60.7%,16.9% and 8.4%,respectively.The univariate analysis showed that radical resection,radiotherapy and RFI≥6 months predicted significantly better outcome（P=0.033,P=0.006 and P=0.001）.The multivariate analysis revealed that radiotherapy and RFI≥6 months were the independent prognosis factors（P=0.047 and P=0.012,respectively）.One thousand six hundred and eight cases of recurrent PNET patients were reported abroad since A.D.2000.The initial recurrence was most often distant only（1089 cases）,followed by local only（292 cases） and both distant and local（227 cases）.Median RFI ranged