食管癌患者脑转移后生存及预后相关因素研究  

Analysis of survival-and prognosis-related factors of brain metastasis from esophageal cancer

作　　者：宋欣[1] 宋晖[1] 彭华 李红卫[1] 张霞琴[1] 梁玉[1] 

机构地区：[1]山西省肿瘤医院放疗科,太原030013

出　　处：《中国医师杂志》2017年第9期1338-1340,共3页Journal of Chinese Physician

基　　金：山西省卫生计生委科研课题（2014053）

摘　　要：目的探讨食管癌脑转移的发生率、脑转移后生存的相关因素和不同治疗方法的患者预后。方法回顾性分析2000年1月至2016年10月本院收治的11338例食管癌患者临床资料。采用kaplan—meier法计算生存率并行Logrank法单因素预后分析。结果发生脑转移84例，其中鳞癌74例，腺癌6例，小细胞未分化癌4例；单发脑转移19例，多发脑转移65例；其中59例有脑转移症状，58例同时出现颅外转移；原发灶与脑转移灶间隔时间〈6个月31例，6～12个月24例，〉12～24个月16例，〉24—36个月13例。全部患者随访时间为2．33—288．03个月（中位随访时间19．31个月），脑转移后生存期0～29．20个月（中位生存期5．43个月）。结论大约0．7％的食管癌发生脑转移，单因素预后分析显示有无颅外转移、递归分隔分析（RPA）分级、KPS评分、脑转移灶不同的治疗方法是食管癌脑转移的预后影响因素。Objective To explore the incidence of brain metastases from esophageal cancer, survival-related factors after brain metastases, and the result of different treatment methods. Methods From January 2000 to October 2016 treated 11 338 cases of esophageal cancer patients, 84 cases of brain metastases, were collected with complete clinical data. Results Eighty four cases of patients with brain metastases included esophageal squamous carcinoma in 74 cases, adenocarcinoma in 6 cases, and small cell undifferentiated carcinoma 4 cases; single brain metastases in 19 cases, 65 cases of multiple brain metastases included 59 cases with brain metastasis symptoms, 58 with extracranial metastases, primary tumors and brain metastases interval time less than 6 months in 31 cases, 24 cases of 6 - 12, 16 cases for 12 - 24 months. Prognostic logrank univariate analysis of survival rate found 24 - 36 months survival for 13 patients. All patients were followed for a median of 19. 31 months after brain metastases, the median survival time was 5.43 months. Conclusions About 0. 7% of brain metastases from esophageal cancer occurs. Esophageal carcinoma metastatic to the brain： There was no extracranial metastasis, rccursive partitioning analysis classification （RPA）, Karnofsky （KPS） score, brain metastases different treatment methods is a poor prognostic factor for esophageal cancer brain metastasis.

关 键 词：食管癌/病理学 脑肿瘤/继发性/流行病学 存活率 预后 

分 类 号：R735.1[医药卫生—肿瘤]