非小细胞肺癌脑转移综合治疗的疗效分析  

Clinical study of combined treatment for brain metastases from non-small cell lung cancer

作　　者：单娟[1] 吴慧[1] 刘海龙[1] 

机构地区：[1]河南省肿瘤医院放疗科,河南郑州450003

出　　处：《中华肿瘤防治杂志》2010年第24期2049-2052,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨非小细胞肺癌(NSCLC)脑转移不同治疗方法的疗效分析及预后因素。方法:回顾性分析2001-01-2006-06我科治疗的71例NSCLC脑转移患者,14例行手术+放疗±化疗,26例行单纯放疗,31例行放疗+化疗。42例行全脑放疗±局部加量,29例行全脑放疗+三维适形调强放疗。全部病例定期随访直至死亡,分别行单因素和多因素分析。结果:全组中位生存期为10个月,1、2和3年生存率分别为29.58%(21/71)、16.90%(12/71)和8.45%(6/71)。单因素分析显示,KPS评分、病理类型、脑转移数目、脑转移大小、原发灶控制、中枢外转移、治疗方法、放疗剂量、放疗方式和近期疗效对生存期有影响。多因素分析显示,KPS评分、脑转移数目、原发灶控制、中枢外转移和近期疗效是独立的生存预后因素。结论:NSCLC脑转移的主要预后因素是KPS评分、脑转移数目、原发灶控制、中枢外转移、近期疗效。积极治疗可适当延长生存期。OBJECTIVE：To examine the efficacy of different treatments on non-small cell lung cancer（NSCLC） with brain metastasis,and evaluate factors affecting the survivals.METHODS：The data of 71 patients from Jan 2001 to Jun 2006 were retrospectively reviewed.Fourteen patients received brain surgery and radiotherapy or chemotherapy,26 patients received single radiotherapy,31 patientsreceived radiotherapy and chemotherapy.Totally 42 patients received whole brain radiotherapy or partly radiotherapy,29 patients received whole brain radiotherapy and three-dimensional conformal radiotherapy.All of these patients were followed up until their death.The Kaplan-Meier method was used to analyze the survial,and Logrank test was used to evaluate the difference between the groups.The cox regessive model was used to analyze the prognostic factors.RESULTS：The overall 1-,2-,and 3-year survival rates were 29.58%（21/71）,16.90%（12/71） and 8.45%（6/71） respectively,with a median survival time of 10 months.The single factor analysis showed that KPS,histological type,the number of brain metastasis,the size of brain metastasis,primary disease control,presence of metastasis other than brain,the therapy methods,the doses of radiotherapy,the method of radiotherapy,and the curatived effect to brain cancer metastasis lump recently had an influence to survival period.In multivariate analysis,KPS,the number of brain metastasis,primary disease control,presence of metastasis other than brain,and the curatived effect to brain cancer metastasis lump recently were independent prognostic factors.CONCLUSIONS：The main prognostic factors of brain metastases from NSCLC are KPS,the number of brain metastasis,primary disease control,presence of metastasis other than brain,and the curatived effect to brain cancer metastasis lump recently.The survival is prolonged by proper treatment.

关 键 词：癌 非小细胞肺 脑转移 预后 因素分析 

分 类 号：R734.2[医药卫生—肿瘤]