囊性征象肺癌脑转移瘤放疗近期疗效的评价时间窗和方法探讨  

Evaluation time window and method of the recent curative effect after radiotherapy of cystic lung cancer with brain metastasis

作　　者：刘宇峰[1] 苏胜发[2] 欧阳伟炜[2] 马筑[2] 李青松[2] 王羽[2] 栗蕙芹[2] 卢冰[2] 

机构地区：[1]贵州医科大学肿瘤学教研室,贵州贵阳550004 [2]贵州省肿瘤医院.贵州医科大学附属医院胸部肿瘤科,贵州贵阳550004

出　　处：《中华肿瘤防治杂志》2016年第6期394-399,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：贵州省科学技术自然基金[黔科合J字(2010)2186号];贵州省科技计划[黔科合SY字(2012)3097号]

摘　　要：目的囊性肺癌脑转移瘤由于放疗后评价疗效或与神经系统临床表现不一致，本研究探讨囊性脑转移瘤放疗后评价近期疗效的时间窗和方法。方法回顾分析贵州省肿瘤医院2008—08—01～2014—09-30收治214例肺癌脑转移完成放疗患者的近期疗效，对比其中95例神经系统临床表现改善患者的囊性和实性转移瘤的近期疗效，探讨设计的脑转移瘤评价方法。结果全组囊性和实性瘤放疗后≤1周的近期疗效差异无统计学意义，P值分别为0．165和0．277。放疗后临床表现改善95例患者中，参照WHO标准评价≤1周近期疗效，结果实性组比囊性组的有效率显著增高，x2=4．876，P=0．027；参照RECIST标准，有效率也具有增高的趋势，x2=3．610，P=0．057。治疗后1～3个月，2种标准评估囊性和实性脑转移瘤的近期疗效差异均无统计学意义，P值分别为0．975和0．953。提示WHO和RECIST标准评价囊性病灶疗效的合适时间窗为放疗后1～3个月。设计“囊壁厚度治疗前后变化”评价近期疗效（≤1周），以“囊壁垂直径乘积”评价近期疗效，对比WHO、RECIST标准与实体瘤的差异无统计学意义，P值分别为0．087和0．751；以“囊壁最大径”评价，差异也无统计学意义，P值分别为0．220和0．858。结论囊性肺癌脑转移瘤放疗后评价时间窗可能为1～3个月，“囊壁厚度变化”评价囊性瘤近期疗效可能更合适。OBJECTIVE For cystic lung cancer brain metastases, due to the inconsistence between the evaluation of therapeutic effect after radiotherapy and the clinical symptoms of the nervous system, this study was aimed to investigate the time window and method to evaluate the efficacy of radiotherapy for brain metastasis. METHODS A retrospective analysis of short-term efficiency of 214 cases was conducted, for the patients with brain metastases from lung cancer who completed radiotherapy and admitted to Cancer Hospital of Guizhou province from 2008-08-01 to 2014-09-30, and a corn parison of short-term efficiency of cystic and solid transfer tumors for the 95 patients with a manifest improvement in clin ieal neuroiogieai system was also conductd to research the evaluation method for the brain metastases. RESULTS There was not statistical significance for the difference of short-term efficiency of cystic and solid tumors after radiotherapy less than i week, P-values were 0. 165 and 0. 277 respectively. For the 95 patients with improvement in clinical symptoms after radiotherapy, according to WHO standard for clinical evaluation of short-term efficiency less than one week, the results showed that the effective rate of solid group was significantly higher than the cystic group, x2 =4. 876 ,P=0. 027. According to RECIST standard, effective rate was in increasing tendency, X2 = 3.610, P= 0. 057. There was no statistical significance for the difference of short-term efficiency of cystic and solid tumors 1- 3 months after radiotherapy in two standards, the P-value were 0. 975 and 0. 953 respectively. According to WHO and RECIST standards, the appropriate time window for evaluating the effect of cystic lesions after radiotherapy was 1--3 months. ＂The changes of wall thickness before and after treatment＂ was used to evaluate short-term efficiency （less than 1 week）, ＂the product of vertical and diameter of wall thickness＂ to evaluate short-term efficiency, when comparing between WHO and RECIST criteria and solid tumors,

关 键 词：肺癌 囊性脑转移瘤 放疗 疗效评价 

分 类 号：R734.2[医药卫生—肿瘤]