1-3个肺癌脑转移灶患者放疗疗效及预后分析  

Whole brain radiation with 3D-CRT/IMRT boost for patients with 1-3 brain metastases from lung cancer

作　　者：李月敏[1,2,3] 张玉海[1] 朱建华[4] 张娜[1] 曲怡梅[1] 武勇[1] 何宇锋[1] 夏火生[1] 韩守云[1] 

机构地区：[1]解放军309医院肿瘤中心,北京100091 [2]解放军总医院 [3]解放军军医进修学院,北京100853 [4]解放军总医院第二附属医院肿瘤中心,北京100037

出　　处：《现代肿瘤医学》2010年第12期2368-2371,共4页Journal of Modern Oncology

基　　金：中国博士后科学基金(20090461439)

摘　　要：目的:探讨1-3个肺癌脑转移灶患者行全脑放疗后病灶局部适形/调强放疗加量的疗效和耐受性。方法:回顾性分析2008年1月至2010年3月对76例1-3个脑转移灶肺癌患者进行全脑放疗后病灶局部放疗加量的疗效和副反应。生存分析采用Kaplan-Meier法,多因素COX回归分析影响患者预后的因素,各亚组之间的差异比较采用Logrank检验。结果:全组随访1.4-51个月,平均18.6个月,临床缓解率为73%,临床获益率92%。1年生存率34%,2年生存率20%。中位生存时间为9.6月,仅1个颅内转移灶的患者中位生存时间为11.4个月,2-3个转移灶的患者中位生存时间为7.8个月。无Ⅲ-Ⅳ级血液学以外的副反应出现。结论:适形/调强放疗技术肿瘤局部加量配合全脑放疗疗效确切,患者有很好的耐受性,可以延长患者寿命,提高生存质量。Objective：To evaluate the efficacy and prognosis of whole brain radiation with 3D-CRT/IMRT boost for patients with 1-3 brain metastases from lung cancer.Methods：From January 2008 to March 2010,Seventy-six lung cancer patients with 1-3 brain metastases received whole brain radiation followed by 3D-CRT/IMRT boost.We retrospectively analyzed the data of these patients.Survival rate was estimated by Kaplan-Meier method.Multi-factor Cox regression was used to analyze the prognostic factors.Log-rank test was applied to analyse the differences of survival rate between sub-groups.Results：All patients were followed up for 1.4-51 months（median 18.6 months）,the clinical response rate was 73%.1 year overall survival was 34%,2 years overall survival was 20%.Median survival time was 9.6 months.Overall survival in patients with 1 brain metastasis and 2-3 metastasis were 11.4 months and 7.8 months respectively.Multi-factor analysis showed that the KPS score,control of primary tumor,age,number of brain metastases were independent prognostic factors.There were no grade 3 /4 non-haematological toxicities.Conclusion：Whole brain radiation with 3D-CRT/IMRT boost was an effective method for patients with 1-3 brain metastases from lung cancer,which could prolong survival time and improve quality of life.

关 键 词：放射治疗 肺癌脑转移瘤 适形/调强放疗 

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