放疗时机对非小细胞肺癌脑部转移患者生存状况的影响  

Effect of radiotherapy timing on the survival in patients with brain metastases from non-small cell lung cancer

作　　者：丁华[1] 季海峰 吴志军[1] 易琼[1] 

机构地区：[1]江苏省南通市肿瘤医院放疗科,南通226000 [2]江苏省如皋市广慈医院放疗科,如皋226500

出　　处：《中国肿瘤临床与康复》2017年第12期1425-1427,共3页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：吴阶平医学基金会2015年科技发展项目(320.6750.14326)

摘　　要：目的探讨放疗时机对非小细胞肺癌脑部转移患者生存状况的影响。方法选取2013年1月至2016年9月间江苏省南通市肿瘤医院收治的68例非小细胞肺癌脑部转移患者。48例患者接受同时性脑放疗和全身治疗,即早放疗组。20例患者接受至少两个周期的全身治疗后,行延迟性脑放疗,即晚放疗组。比较两组患者的临床指标、初始进展部位及不良反应。结果早放疗组无进展生存时间为(5.00±0.98)个月,明显高于晚放疗组的(3.00±0.79)个月,早放疗组总生存时间为(17.90±1.21)个月,明显高于晚放疗组的(12.60±1.35)个月,差异均有统计学意义(均P<0.05)。早放疗组患者脑内转移为29.2%,颅外转移70.8%;晚放疗组患者脑内转移为45.0%,颅外转移55.0%,差异均有统计学意义(均P<0.05)。两组患者并发症发生情况比较,差异无统计学意义(P>0.05)。结论非小细胞肺癌脑部转移患者早期放疗,可延长无进展生存时间,推迟脑化疗可能会对患者的生存时间造成影响。Objective To explore the effect of radiotherapy timing on the survival in patients with brain metastases of non-small cell lung cancer（ NSCLC）. Methods Sixty-eight NSCLC patients with brain metastases were selected at Nantong Tumor Hospital from January 2013 to September 2016. Of them,48 patients received concurrent brain radiotherapy and systemic therapy（ early radiotherapy group） and 20 patients received delayed brain radiotherapy after receiving at least two cycles of systemic treatment（ late radiotherapy group）. The clinical indexes,initial progress site and adverse reactions were compared between the two groups. Results The progression-free survival（ PFS） was 5. 00 ± 0. 98 months for the early radiotherapy group which was significantly higher than 3. 00 ± 0. 79 months. The overall survival（ OS） was 17. 90 ± 1. 21 months for the early radiotherapy group which was significantly higher than 12. 60 ± 1. 35 months of the late radiotherapy group（ all P〈0. 05）. For the initial progress,intracranial metastasis occurred in 29. 2% patients,extracranial metastasis occurred in 70. 8% patients in the early radiotherapy group and intracranial metastasis occurred in 45. 0% patients and extracranial metastasis occurred in 55. 0%patients in the late radiotherapy group. There was no statistically significant difference in the complication（ P〈0. 05）. Conclusion Early radiotherapy can prolong survival time and delay the adverse effects of brain chemotherapy on the survival in NSCLC patients with brain metastases.

关 键 词：放疗时机 癌 非小细胞肺 脑部转移 生存状况 

分 类 号：R734.2[医药卫生—肿瘤]