手术切除单发脑转移瘤的预后及相关因素分析  

Prognostic factors correlated with survival among patients with surgically resected single brain metastases

作　　者：孙国臣[1] 马晓东[1] 许百男[1] 余新光[1] 陈新静[2] 任贺成[1] 李扬[1] 

机构地区：[1]解放军总医院神经外科,北京100853 [2]解放军总医院放疗科,北京100853

出　　处：《临床神经外科杂志》2008年第1期20-22,26,共4页Journal of Clinical Neurosurgery

摘　　要：目的回顾性分析手术切除单发脑转移瘤病人的预后及其影响因素。方法收集解放军总医院神经外科1996—2006手术切除的102例单发脑转移病人临床资料，对预后相关因素进行统计学分析。结果经多变量分析，对改善预后有统计学意义的变量包括：年龄小于65岁，没有颅外转移，原发病灶控制，KPS生活状态评分≥70，病理为非小细胞肺癌，立体定向放射外科治疗。所有病人的中位生存期是10个月。RPA（Recursive partitioning analysis classes）1级的病人预后好于2级和3级。接受立体定向放射外科治疗病人的中位生存期显著高于未接受者。结论RPA分级在预测手术切除＋辅助治疗的单发脑转移瘤的预后中具有重要意义，RPA1级预后良好，中位生存期为12月。Objective To retrospectively evaluate prognostic factors correlated with overall survival among patients with surgically resected single brain metastases. Methods Clinical data of 102 patients with single brain metastases treated by surgical resection from 1996 to 2006 in PLA General Hospital was analyzed. Results Statistically significant variables for improved survival on multivariate analysis included age 〈 65 years, no extracranial metastases, control of primary tumor, KPS≥70, histology （non-small-cell lung carcinoma） , whole-brain radiation therapy and stereotactic radiosurgery. The median survival for all patients was 10 months. Survival of patients in recursive partitioning analysis （RPA） class 1 was better than those in class 2 and class 3. Patients treated with stereotactic radiosurgery after surgery had a longer median survival than those not treated with stereotactic radiosurgery. Conclusions This analysis supports the prognostic significance of the RPA classification in patients with a single brain metastases who undergo surgical resection and adjuvant therapy. RPA class 1 patients have a very favorable prognosis with a median survival of 12 months.

关 键 词：脑转移瘤 外科切除 RPA分级 

分 类 号：R730.264[医药卫生—肿瘤]