非小细胞肺癌脑转移122例预后因素分析  

Analysis of prognostic factors in 122 non-small-cell lung cancer patients with brain metastasis

作　　者：蒋鹏[1] 吴阳[1] 辛勇[1] 姚元虎[1] 章龙珍[1] 

机构地区：[1]徐州医学院附属医院放疗科,221002

出　　处：《肿瘤研究与临床》2015年第9期612-616,共5页Cancer Research and Clinic

摘　　要：目的：探讨非小细胞肺癌（NSCLC）脑转移患者预后的影响因素。方法回顾性分析2007年1月至2012年12月收治的122例NSCLC脑转移患者临床及随访资料，以死亡为结局，NSCLC脑转移患者预后的影响因素。以Kaplan-Meier方法进行生存分析，Log-rank检验进行单因素分析，Cox回归模型进行多因素分析。结果经单因素及多因素分析显示影响NSCLC脑转移患者预后的相关因素包括患者年龄、病理类型、颅内转移灶数目、是否存在颅外转移、治疗方式、Karnofsky评分、原发灶控制情况（P＜0.05），而性别、原发灶直径与NSCLC脑转移患者的预后无关（P＞0.05）。姑息对症治疗、单纯全脑放疗、全脑放疗局部病灶加量放疗、全脑放疗局部病灶加量放疗联合化疗的患者平均生存时间分别为（2.14±0.19）个月、（7.28±0.60）个月、（16.90±1.35）个月、（17.7±1.12）个月，1年生存率分别为0、8.5%、71.0%、93.3%，四组之间差异有统计学意义（P＝0.000）。结论NSCLC脑转移患者年龄、病理类型、颅内转移灶数目、是否存在颅外转移、治疗方式、Karnofsky评分、原发灶控制情况是预后的影响因素，在治疗上应综合分析，全面把握患者临床资料。Objective To explore the prognostic factors of non-small-cell lung cancer （NSCLC） patients with brain metastasis. Methods 122 NSCLC patients with brain metastasis from Jan 2007 to Dec 2012 were incorporated, and followed with death as the end. The influence factors of prognosis were retrospective analyzed. Kaplan-Meier method was used for survival analysis, the Log-rank test for single factor analysis,and Cox regression model for multiple factors analysis. Results The single-factor and multi-factor analysis showed that the influence factors of prognosis were age, pathological type, number of intracranial metastasis, presence of extracranial metastasis, treatment, Karnofsky score, the original site control situation （P〈0.05）. Gender, the size of the original site had no influence for prognosis （P〉0.05）. The average survival times of patients with palliative symptomatic treatment, simple whole brain radiotherapy, whole brain radiotherapy local lesion plus the amount of radiation, whole brain radiotherapy local lesion plus the amount of radiation combined with chemotherapy were （2.14 ±0.19） months, （7.28 ±0.60） months, （16.90 ±1.35） months, （17.7±1.12） months, 1 year survival rates were 0, 8.5%, 71.0%, 93.3%. Survival analysis showed that there was statistical significance among the four groups （P= 0.000）. Conclusion The age, pathological type, number of intracranial metastasis, presence of extracranial metastasis, treatment, Karnofsky score, the original site control situation are the prognosis factors in NSCLC patients with brain metastasis, therefore the treatment of these patients should be comprehensively analyzed.

关 键 词：癌 非小细胞肺 脑转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]