伽玛刀治疗40例骨肉瘤肺转移患者的生存分析  

Survival analysis of gamma knife treating 40 osteosarcoma patients with pulmonary metastasis

作　　者：王春燕[1,2] 汤丽娜[2] 祁伟祥[2] 张剑军[2] 孙元珏[2] 姚阳[2] 林峰[2] 

机构地区：[1]苏州大学医学部,江苏苏州215000 [2]上海交通大学附属第六人民医院肿瘤内科,上海200233

出　　处：《中华肿瘤防治杂志》2015年第8期633-636,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：上海市卫生局科研课题(20114171)

摘　　要：目的探讨伽马刀治疗骨肉瘤肺转移患者的生存情况,并分析影响其预后的相关因素。方法回顾性分析上海交通大学附属第六人民医院2008-01-01-2012-12-31共40例骨肉瘤肺转移患者接受伽马刀治疗的临床资料,使用Kaplan-Meier法绘制生存曲线,并采用Log-rank进行单因素检验,并通过Cox回归模型分析与患者生存有关的独立影响因素。结果 40例骨肉瘤肺转移患者2年生存率为42.5%,中位生存时间为27个月,95%CI为19.4~34.6个月。Log-rank单因素分析结果显示,伽玛刀治疗骨肉瘤肺转移患者的预后与性别（P=0.901）、年龄（P=0.903）、KPS评分（P=0.936）、单/双肺转移（P=0.522）、有无肿瘤原发部位的复发（P=0.985）、有无除肺以外的远处转移（P=0.333）、原发部位的手术方式（P=0.359）及有无行新辅助化疗（P=0.415）均无关,而与肺转移瘤数目有关,P=0.032。Cox模型多因素回归分析结果显示,肺转移瘤数目是影响预后的独立相关因素,P=0.039。结论伽玛刀治疗骨肉瘤肺转移患者预后较好,值得做进一步临床研究。肺转移瘤数目对接受伽玛刀治疗的肺转移患者的生存时间有影响。OBJECTIVE To Investigate the survival status of gamma knife treating osteosarcoma patients with lung metastasis,and to analyze the prognostic factors for the 40 patients. METHODS Forty osteosarcoma patients with pulmo- nary metastasis accepting gamma knife treatment were retrospectively reviewed from 1st January 2008 to 31st December 2012 in Six People＇s Hospital,Shanghai Jiaotong University. Kaplan-Meier method was used to calculate the overall sur- vival time and to draw the survival curve. The univariate analysis of prognosis was performed by log-rank test. The multi- variate Cox regression was used to analyze the relationship between these factors and the overall survival time. RESULTS Two-year survival rate for the 40 patients was 42.5 %, the median overall survival time was 27 months, 95 % confidence interval was 19.4--34.6 months. The univariate analysis showed that there was no significant differences in terms of gen- der （P=0. 901） ,age （P=0. 903） ,Karnofsky performance-status （KPS） score （P=0. 936） ,unilateral or bilateral lung me- tastasis （P=0. 522）,operation process of the local tumor （P=0. 359）, neoadjuvant chemotherapy （P= 0. 415）, local recurrence （P=0. 985） and metastasis of other sites （not lung） （P=0. 333） ,while the different number of lung lesions were related to the survival curve, （P= 0. 032）. Multivariate regression analysis showed that the number of lung metastasis lesions were independent prognostic factor （P=0. 039）. CONCLUSIONS The prognostic of Gamma knife used in osteosarcoma patients with lung metas- tasis is effective, further clinical studies are still needed. The number of lung metastasis lesions could affect the overall survival time of osteosarcoma patients with lung metastasis treated with Gamma knife.

关 键 词：骨肉瘤 肺 肿瘤转移 伽玛刀 预后 

分 类 号：R738.1[医药卫生—肿瘤]