三阴乳腺癌脑转移患者全脑放疗联合精确放疗疗效及预后分析  

Efficacy and prognosis of whole brain irradiation combined with accurate radiotherapy on triple negative breast cancer

作　　者：罗波[1] 吴新红[1] 罗燕[1] 

机构地区：[1]湖北省肿瘤医院放疗科,武汉430079

出　　处：《立体定向和功能性神经外科杂志》2012年第5期301-304,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：国家自然科学基金资助项目(编号:81201795)

摘　　要：目的探讨三阴乳腺癌脑转移全脑放疗联合调强或三维适形放疗的疗效和预后。方法回顾性分析在本院放疗的112例乳腺癌脑转移患者的临床资料,其中37例为三阴乳腺癌,所有病例先行全脑照射然后缩野至局部病灶行调强或三维适形推量照射。比较三阴组和非三阴组近期疗效,并采用Kaplan-Meier法分析三阴乳腺癌生存期,Log-rank test比较其与非三阴组差异。采用多因素Cox比例风险回归分析了乳腺癌脑转移精确放疗的潜在预后因素。结果放疗后三阴组乳腺癌患者和非三阴组患者有效率为分别为96.2%和97.0%,比较无差异。三阴组和非三阴组中位生存期分别为6.9个月和17个月(P<0.01)比较有差异。多因素分析显示GPA(graded prognostic assessment)分级和三阴表型及是否合并活动性颅外转移灶及为独立的预后因素。结论三阴表型乳腺癌全脑放疗后行精确放疗推量后,能够取得较好的客观缓解率,但其生存期较非三阴组短。而对于行全脑联合精确放疗的乳腺癌脑转移患者,是否三阴表型是其独立的生存预后因素。Objective To investigate treatment efficacy and survival times in breast cancer patients with triple-negative（TN） phenotype who had brain metastases underwent whole brain irradiation combined with accurate radiotherapy. Methods A total of 112 breast cancer patients with brain metastases were treated with whole brain irradiation followed with IMRT or 3DCRT was analysed.Thirty seven patients were TN.Objective response rates were compared,and survival times were estimated using the Kaplan-Meier method with a log-rank test computing the survival time difference between groups.potential prognostic factors were determined using a Cox proportional hazard regression model. Results After radiotherapy,TN phenotype associated with worse survival times（6.9 months vs.17 months）,（P0.01）.On multivariate analysis,good prognosis was associated with non-TN status,lower graded prognosis assess class and none existence of active extracranial metastases. Conclusion After treated whole brain irradiation followed by IMRT or 3DCRT,breast cancer patients with TN phenotype who harbors intracranial metastasis have high objective response rates and shorter survival.The TN phenotype represents a significant adverse prognostic factor with respect to survival in breast cancer patients with intracranial metastasis.

关 键 词：三阴表型 乳腺癌 脑转移 精确放疗 

分 类 号：R737.9[医药卫生—肿瘤]