影响非小细胞肺癌脑转移患者放射治疗后生存的临床相关因素分析  

Clinically analysis of the survival time for NSCLC patients with brain metastases after radiotherapy

作　　者：傅华[1] 许瑜[2] 田仲泽[1] 岳养军[1] 

机构地区：[1]兰州军区兰州总医院肿瘤中心,甘肃730050 [2]第三军医大学新桥医院全军呼吸疾病研究所,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2014年第3期41-44,共4页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的 探讨非小细胞肺癌（NSCLC）脑转移患者放射治疗后的预后转归及影响患者生存期的相关因素.方法 回顾性分析2004年1月至2010年11月在我院诊治的NSCLC脑转移放疗后103例患者的资料.采用Kaplan-Meier法进行生存分析,以Log-Rank检验比较各亚组生存率差异,采用风险比例模型（COX模型）进行多因素生存相关危险因素分析.结果 103例NSCLC脑转移放疗后患者总体生存期为1～68个月;中位生存期为10个月（95％CI：7.231～ 12.769个月）,1年生存率为46.0％,2年生存率为22.0％;COX多因素分析结果 显示：体能状态评分（ECOG）、分级预后评估指数（GPA）是影响患者生存率的独立预后因素（P =0.024,P=0.000）.Log-Rank检验行GPA亚组分析显示,4组间生存曲线有显著性差异（P=0.000）.结论 ECOG评分、GPA是影响NSCLC脑转移放疗后患者生存率的独立预后因素;GPA指数模型可以反映放射治疗后NSCLC脑转移患者的预后.Objective Systematicly analyze the risk factors that influence the progonosis and survival of non-small cell lung caner （NSCLC） patients with brain metastases after brain radiotheray. Methods To collect 103 NSCLC patients with brain metastases treated in ours Hospital from January 2004 to November 2010. To analyze the survival time by kaplan-Meier. The differences of survival rate in all groups were analyzed with Log-rank test. To analyze muhifactor survival relatived risk factors by COX model was used. P 〈 0.05 means significant difference. Results In 103 NSCLC patients with brain metastases, the overall survival duration was 1-68 months after brain radiotherapy; Median survival was 10 months （95% CI：7. 231-12. 769 months） ; 1 year and 2 year survival rate was 46.0%, 22.0% respectively. COX multiplicity showed： ECOG scores and GPA index was independent prognosis factor that influence survival rate （P = 0. 024, P = 0. 000）. According to GPA index building model of prognosis, the survival rate between 4 groups was significant difference （P = 0. 027, P = 0. 000）. Conclusions ECOG scores and GPA index was the independent prognosis factors influenced the survival rate ; GPA index can reflect the prognosis of NSCLC patients with brain metastasis after radiotherapy.

关 键 词：非小细胞肺癌 脑 肿瘤转移 生存率 影响因素 

分 类 号：R734.2[医药卫生—肿瘤] R563[医药卫生—临床医学]