非小细胞肺癌脑转移患者全脑放疗效果及预后影响因素分析  

Outcome and prognostic factors in patients with brain metastases from non-small cell lung cancer treated with whole brain radiotherapy

作　　者：项振飞 方建晨[2] 林丽 陆妙珍[4] 许权[4] 田辉 XIANG Zhenfei;FANG Jianchen;LIN Li(Department of Radiotherapy,Ningbo Medical Center Lihuili Eastern Hospital,Taipei Medical University Ningbo Medical Center,Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利东部医院(台北医学大学宁波医疗中心)放疗科,315040 [2]宁波市医疗中心李惠利医院病理科 [3]宁波市鄞州区人民医院血液科 [4]宁波市医疗中心李惠利医院放疗科 [5]宁波市医疗中心李惠利东部医院(台北医学大学宁波医疗中心)胸外科,315040

出　　处：《浙江医学》2018年第21期2325-2329,共5页Zhejiang Medical Journal

摘　　要：目的探讨非小细胞肺癌(NSCLC)脑转移患者全脑放疗(WBRT)效果及预后影响因素。方法选取129例接受WBRT的NSCLC脑转移患者,其中48例接受局部加量放疗。跟踪随访2年,记录半年、1年及2年生存率,分析总生存期(OS)及无复发生存期(RFS)情况。采用Cox比例风险回归模型分析NSCLC脑转移预后的影响因素,绘制生存曲线以进一步分析颅外器官转移数、颅外原发灶近期疗效对预后的影响。结果 129例NSCLC脑转移患者OS为(10.6±0.69)个月,接受WBRT后半年、1年及2年生存率分别为64.3%、45.0%和17.1%,2年复发率为79.8%。诊断脑转移后化疗周期数、靶向治疗、颅外原发灶近期疗效、颅外转移器官数是NSCLC脑转移预后的独立影响因素(均P<0.05)。结论诊断脑转移后化疗周期数、靶向治疗、颅外原发灶近期疗效、颅外转移器官数可影响NSCLC脑转移患者的预后,临床制定个体化治疗方案时可作为参考。Objective To investigate prognostic factors of non-small cell lung cancer(NSCLC)with brain metastasis.Methods One hundred and twenty nine NSCLC patients with brain metastases underwent the whole brain radiotherapy(WBRT),among whom 48 cases accepted local boost radiotherapy.All patients were followed up for two years.The 6-month,1-year and 2-year overall survival and relapse free survival were documented.Cox proportional hazards regression model was used to analyze the prognostic factors of NSCLC patients with brain metastases,and the effects of number of organs with extraneural metastases and the short-term efficacy of extracranial primary foci on prognosis were further analyzed by drawing survival curve.Results The 6-month,1-year and 2-year overall survival rates were 64.3%,45.0%and 17.1%respectively,with an overall survival time of(10.6±0.69)months.Additionally,the recurrence rate in 2 years was 79.8%.The Cox proportional hazards regression model showed that chemotherapy times after diagnosis of brain metastases,targeted therapy,short-term efficacy of extracranial primary foci and number of organs with extraneural metastases were independent prognostic factors of NSCLC patients with brain metastasis(P<0.05).Conclusion The chemotherapy times,targeted therapy,short-term efficacy of extracranialprimary foci and number of organs with extraneural metastases would affect the prognosis of NSCLC patients with brain metastasis undergoing whole brain radiotherapy.

关 键 词：非小细胞肺癌 脑转移 全脑放疗 预后因素 生存分析 

分 类 号：R734.2[医药卫生—肿瘤]