肺癌脑转移的时间分布和生存分析  

An Analysis on Time Distribution and Survival of Brain Metastases in Patients with Lung Cancer

作　　者：胡胜[1] 杨玲[2] 谭文勇[2] 柯玉华[2] 李密[2] 宋启斌[1] 

机构地区：[1]武汉大学人民医院肿瘤中心,湖北武汉430060 [2]湖北省肿瘤医院,湖北武汉430079

出　　处：《中国肿瘤》2007年第12期1027-1030,共4页China Cancer

基　　金：湖北省卫生厅基金项目(JX1B149)

摘　　要：[目的]分析肺癌脑转移的时间分布特点,及对患者生存时间的影响。[方法]收集1990￣1993年(Ⅰ组,996例)和2000￣2003年(Ⅱ组,1331例)肺癌患者2327例,分析诊断肺癌—脑转移时间,治疗肺癌—脑转移的时间;以及组织类型、性别、年龄、PS评分、分期、铂类化疗与脑转移的关系。[结果]在所有病例中,Ⅰ组脑转移的发生率为6.8%,低于Ⅱ组的11.5%(χ2=14.6,P<0.01)。脑转移的发生与组织类型、性别、PS评分、分期、是否铂类化疗无关,但<50岁的患者有更高的脑转移发生率。在Ⅰ组和Ⅱ组,诊断—脑转移中位时间分别为3.8个月和4.9个月,治疗—脑转移的时间分别为2.7个月和3.8个月。Ⅰ组生存中位时间为12.1个月,明显低于Ⅱ组13.0个月(P<0.01)。Ⅰ组脑转移患者总体生存中位时间3.7个月;低于Ⅱ组4.5个月(P<0.01)。[结论]肺癌脑转移的发生率近年明显上升,与患者的年龄有关。[Purpose] To evaluate time distribution of brain metastases in patients with lung cancer, and influence of brain metastases on overall survival. [Methods] A total of 2327 cases with lung cancer were collected from 1990-1993 （group Ⅰ , 996 cases ） and 2000-2003 （group Ⅱ ,1331 cases）. The time from diagnosis to brain metastases, the time from beginning treatment to brain metastases and the relationship of brain metastases with histology, age, gender, PS scoring and cisplatin chemotherapy were investigated. [Results] The occurrence rate of brain metastases in group I was lower than that in group Ⅱ （6.8% vs 11.5%, X^2=14.6, P〈0.01）. Brain metastases didn＇t correlate with histology, gender, PS scoring, stage, or chemotherapy, but increased in patients with〈50 years old. Median time from diagnosis to brain metastases was 3.8 months in group Ⅰ, 4.9 months in group Ⅱ. Median time from treatment to brain metastases was 2.7 months in group Ⅰ , 3.8 months in group Ⅱ. Median overall survival time in group I was 12.1months, which was sholler than that in group Ⅱ （13.0 months）（P〈0.01）. Median overall survival time in patients with brain metastases in group Ⅰ （3.7 months） was significantly lower than that in group Ⅱ（4.5 months）（P〈0.01）. [Conclusions] Lung cancer with brain metastases increases in recent years, it is related to younger age of patients.

关 键 词：肺肿瘤 脑转移 生存时间 

分 类 号：R734.2[医药卫生—肿瘤]