非小细胞肺癌脑转移165例治疗及预后分析  

Treatment and prognosis analysis of 165 non-small cell lung cancer patients with cerebral metastasis

作　　者：黄丹丹[1] 罗裕坤[1] 杨家林[1] 王冀川[1] 颜高姝[1] 阴骏[1] 陈文力[1] 

机构地区：[1]四川省肿瘤医院放疗科,四川成都610041

出　　处：《实用临床医药杂志》2014年第1期105-108,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321223)

摘　　要：目的分析非小细胞肺癌(NSCLC)脑转移患者不同治疗方式对预后的影响。方法回顾性分析本院收治的165例NSCLC脑转移患者的临床资料,其中90例行单纯放疗,20例行单纯化疗,55例行放化联合治疗。所有患者中,79例接受全脑放疗及脑转移灶立体定向放射治疗(WBRT+SRT),92例接受肺部原发灶放疗。对不同治疗方式患者的生存情况进行比较,并分析预后影响因素。结果单纯放、化疗患者中位生存期均为5个月,而同步或序贯放化疗患者中位生存期为11个月;单纯WBRT与WBRT+SRT患者中位生存期分别为4个月和9个月,WBRT+SRT明显优于单纯WBRT,差异有统计学意义;接受肺部原发灶放疗患者中位生存期(11个月)明显优于未接受肺部原发灶放疗的患者(4个月),差异有统计学意义。COX多因素分析发现,肺部放疗为患者独立预后因素。结论 NSCLC脑转移患者预后较差,肺部原发灶放疗是其独立预后因素。Objective To explore the influence of different therapeutic methods on the prognosis of non-small cell lung cancer（NSCLC）patients with cerebral metastasis. Methods Clinical materialsof 165 NSCLC patients with cerebral metastasis were analyzed retrospectively.90 cases were treated with simple radiotherapy,20 caseswere treated with simple chemotherapy and 55 cases were treated with radiotherapy combined with chemotherapy.Among the 165 patients, 79 patients were conducted with whole cerebral radiotherapy and stereotactic radiotherapy（WBRT＋ SRT）for cerebral metastasis and 92 patientswere conducted with radiotherapy for pulmonary primary lesions.The survival conditions of patients treated with different methods were compared, and prognostic influencing factors were analyzed.Results The median survival time of patients treated with simple radiotherapy and chemotherapy was 5 months, while that of patients with concurrent or sequential radiochemotherapy was 11 months. The median survival times of patients treated with simple WBRT and WBRT＋ SRT were 4 and 9 months respectively. The efficacy of WBRT＋ SRT was significantly better than WBRT. The median survival time of patients treated with radiotherapy in pulmonary primary lesions（11 months）was significantly longer than patients without radiotherapy in pulmonary primary lesions（4 months）. COX multiple-factor analysis showed that pulmonary radiotherapy was the independent factor for prognosis of patients.Conclusion The prognosis of NSCLC patients with cerebral metastasisis poor,and primary lesion radiotherapy is the independent factor for prognosis of patients.

关 键 词：非小细胞肺癌 脑转移 放射治疗 立体定向放射治疗 化疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]