三维适形放疗对肺癌脑转移的疗效及预后因素分析  

Efficacy of three-dimensional conformal radiation therapy in treatment of brain metastasis of lung cancer

作　　者：任立杰[1] 韩慧[1] 党升强[1] 李波[1] 刘卓艺[1] 王凤桐[1] 

机构地区：[1]山东省即墨市人民医院肿瘤科,266200

出　　处：《中国肿瘤临床与康复》2008年第3期279-281,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨三维适形放射治疗对肺癌脑转移的治疗效果及影响预后的因素。方法对46例肺癌脑转移患者先给予全颅放疗30Gy,再局部三维适形放疗9～18Gy。分割方法均为3Gy/次,5次/周。与头部同期行肺部放射治疗22例,和(或)后期给予全身化疗26例。结果疗后1～3个月有38例(69个病灶)复查头部CT、MRI,颅内转移瘤有效率为79.7%(55/69);全组神经系统症状改善率91.3%(42/46);中位随访13个月,随访率100%,中位生存期11个月,1,2年生存率分别为46.2%(18/39)和13.3%(2/15)。单因素分析显示,Karnofsky评分、颅内转移瘤放疗剂量、有无颅外转移、体重变化、是否采用综合治疗对生存期有影响。结论肺癌脑转移三维适形放疗疗效满意,放疗并发症少;Karnofsky评分、颅内转移瘤放疗剂量、有无颅外转移、体重变化、是否采用综合治疗是影响生存期的预后因素。Objective To evaluate the efficacy of 3-dimensional conformal radiation therapy（3- DCRT） in treatment of brain metastasis of lung cancer and to analyze the factors influencing the prognosis. Methods Forty-six patients were treated with a whole brain dose of 30 Gy before 3-DCRT of 9-18 Gy, 2 Gy/f,5 f/w. Twenty-two patients received radiation therapy of the lung foci combined with brain therapy and （or）26 received chemotherapy later. Results Brain CT and MRI was performed in 38 cases one to three months after therapy, effective rate of brain metastasis was 79.7% （55/69）, effective rate of CNS symptoms was 91.3% （42/46）. The median follow-up time was 13 months and the 1-and 2-year survival rates were 46.2% （18/39） and 13.3% （2/15）, respectively. Univariate analysis showed that KPS, the dose for brain metastasis, extracranial metastasis, body weight change and combined therapy were prognostic factors for the survival. Conclusions 3-DCRT for treatment of brain metastasis of lung cancer is effective. KiX3, the dose for brain metastasis, extracranial metastasis, body weight change and combined therapy are prognostic factors for the survival.

关 键 词：肺肿瘤 脑转移 三维适形放射治疗 预后 

分 类 号：R734.2[医药卫生—肿瘤] R730.58[医药卫生—临床医学]