脑转移瘤的预后分析  

Prognostic factors of metastatic tumor to the brain

作　　者：李红卫[1] 张霞琴[1] 成静[1] 张美静[1] 韩松岩[1] 

机构地区：[1]山西省肿瘤医院放疗科,太原030013

出　　处：《中华放射肿瘤学杂志》2007年第5期362-365,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 回顾性分析脑转移瘤的预后因素，探讨RTOG脑转移瘤回归分割分析（RPA）分类的适应性。方法 对371例脑转移瘤进行了回顾性分析，主要分析因素有年龄、病理、原发灶控制、KPS评分、Hb值、中枢外转移、治疗方法，分别进行单因素分析和多因素分析。对全组病例根据RTOG标准进行分类，对不同生存情况进行比较。结果 全组中位生存期8．0个月，1、2、3年生存率分别为37．8％、18．4％、12．2％。Cox模型多因素分析显示KPS评分、原发灶控制、治疗方法、转移灶是否为单发为独立预后因素。RPA分类I、Ⅱ、Ⅲ类中位生存期分别为22．0、9．0、5．0个月，3类患者生存期有明显差异。结论 脑转移瘤预后因素主要为KPS评分、原发灶是否控制、颅内转移是否为单发。积极治疗可适当延长患者生存期，RTOG脑转移瘤的RPA分类有较好适应性。Objective To evaluate the prognostic factors of metastatic tumor to the brain and suggest a proposal for individualized treatment with estimation of prognosis. Methods 371 patients with metastatic lesions to the brain were retrospectively analyzed, The chief prognostic factors evaluated were ： gender, age, histological type, primary tumor site, Karnofsky performance status （KPS）, value of Hb, primary tumor control, extracranial metastasis and treatment, Kaplan-Meier method was used to analyze the survival, Logrank test was used to evaluate the difference between the groups, Cox regressive model was used to analyze the prognostic factors, Recursive partitioning analysis （RPA） classification by the standard of RTOG was also compared by Logrank test, Results The overall 1-, 2- and 3-year survival rates were 37. 8% , 18.4% and 12. 2% with a median survival time of 8.0 months. In multivariate analysis, KPS, primary disease control and treatment were independent prognostic factors, The median survival time of classes 1,2 and 3 according to RPA classification was 22. 0, 9. 0 and 5. 0 months, which were significantly different, Conclusions The main prognostic factors of metastatic tumor to the brain are KPS, primary disease control and the number of brain metastasis, The survival is prolonged by proper treatment, The recursive partitioning analysis classification is in accordance with the brain metastasis.

关 键 词：肿瘤转移 脑/放射疗法 预后 因素分析 

分 类 号：R686[医药卫生—骨科学]