肺癌脑转移瘤放疗方案比较临床疗效及预后分析  

Clinical materials comparison of radiotherapy methods of brain metastatic of lung cancer and analysis of prognosis influencing factors

作　　者：刘莲花 杨晓峰 贺方学 黄丙俭 

机构地区：[1]临沂市肿瘤医院放疗科,山东临沂276001

出　　处：《中华肿瘤防治杂志》2014年第2期143-146,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：比较同期推量放射治疗（simultaneousintegratedboostintensity-modulatedradiotherapy，SIB）和全脑照射＋三维适形放射治疗（wholebrainirradiation＋three-dimensionalconformalradiotherapy，WBRT＋3D-CRT）序贯治疗2种方法治疗肺癌脑转移瘤患者的临床资料，并分析影响预后的因素。方法：收集2008—02—01—2010—02—01在我院行SIB（研究组）56例和wBRT＋3D-CRT序贯治疗（对照组）55例的肺癌脑转移瘤患者临床资料。总结与患者预后的相关因素。结果：研究组完全缓解（CR）为71．4％（40／56），对照组为45．5％（25／55），差异有统计学意义，P=0．005。研究组平均住院时间为24d，对照组为44d，差异有统计学意义，P〈O．001。研究组0～3级急性放疗反应分别为43、8、4和1例，对照组分别为44、6、3和2例，差异无统计学意义，P=0．730。2组均无4级急性放疗反应发生。研究组1、2和3年生存率分别为64．3％、32．1％和10．7％，对照组分别为34．5％、20．0％和5．5％，差异有统计学意义，P=0．008。单因素和多因素分析结果均显示，大体肿瘤体积（grosstumorvolume，GTV）、原发灶控制或脑外其他部位转移情况和放疗方法等是影响肺癌脑转移瘤患者预后的因素。结论：SIB能提高肺癌脑转移瘤完全缓解率、缩短住院时间，是影响肺癌脑转移瘤患者预后的独立因素，为肺癌脑转移瘤患者提供了一个简单、精确、周期短和疗效好的放疗方法。OBJECTIVE：To compare the clinical data of treatment for brain metastasis of lung cancer with SIB （sim- ultaneous integrated boost intensity-modulated radiotherapy） and WBRT＋3D-CRT （three-dimensional eonformal radio- therapy） and analyze the prognotic factor of brain metastasis of lung cancer patients. METHODS：The author collected clin- ical materials of treatment for brain metastatic patients of lung cancer with SIB （study group） and WBRT＋3D-CRT（con- trol group） from February I of 2008 to February 1 of 2010,and also summarized factors correlative with patients progno- sis, including gender, age, number of metastatic tumors, GTV volume, radiotherapy method, uncontrolled protopathy or combined metastasis with other position. The author also analyzed patients prognostic factors. RESULTS：Compared remis- sion rate with patients in study group was 71.4%, and that in control group was 45.5%, the difference between study group and control group had statistical significance （P=0. 005）. The mean hospital stay time in study group was 24 days, and that in control group was 44 days,there were significan differece between the two groups （P（0. 001）. The acute ra- diotherapy side effect of 0--3 grades in study group were 43,8,4 and 1, respectively,in control group were 44,6,3 and 2, there were not statistiea differece between the two groups （P= 0. 730）, but grade 4 acute radiotherapy side effect was not occurred in both groups the 1-,2-,3-year survival rate in study group were 64.3 ~/0,32.1% and 10.7 %, in control group were 34.5% ,20.0% ,5.5% and the statistical difference of survival rate between two groups were also remarkable （P= 0. 008）. One-way prognosis analysis showed that there were many major factors affected brain metastasis of lung cancer, such as GTV volume, radiotherapy was SIB or WBRT＋ 3D-CRT,if primary malignancy was controlled or not,if there was metastasis position except brain,and so on. Multifactor prognosis analysis showed that GTV volume,other metastasis po- sit

关 键 词：肺癌脑转移瘤 同期推量调强放射治疗(SIB) 三维适形放疗(3D-CRT) 全脑照射(WBRT) 单因素预后分 析 多因素预后分析 

分 类 号：R734.2[医药卫生—肿瘤]