肺腺鳞癌伴脑转移患者的预后分析  

Prognostic analysis of adenosquamous carcinoma of lung with brain metastasis

作　　者：李廷 赵丽萍 胡佳楠[2] 虞伟妃 周珏伊 蓝燕丽 符丹丽 LI Ting;ZHAO Liping;HU Jianan(Department of Medical Oncology,Lishui People’s Hospital,Lishui 323000,China)

机构地区：[1]赣州市人民医院 [2]丽水市人民医院肿瘤内科,323000

出　　处：《浙江医学》2019年第16期1768-1771,共4页Zhejiang Medical Journal

摘　　要：目的回顾分析肺腺鳞癌伴脑转移患者的预后及相关因素。方法回顾36例伴有脑转移的肺腺鳞癌患者的一般资料,采用Kaplan-Meier法进行生存分析。总生存期(OS)分OS1和OS2,分析影响OS2的相关因素。结果36例患者中13例患者为初诊时伴有脑转移。21例患者经过EGFR基因检测,5例EGFR突变均接受靶向治疗。有30例患者接受全脑放疗。患者从诊断腺鳞癌到确诊脑转移之间的中位时间为6.7个月[(95%CI:5.057~8.343)个月]。36例患者的中位OS1是14.5个月[(95%CI:11.877~17.123)个月],中位0S2是8.5个月[(95%CI:7.658~9.342)个月]。在单因素分析结果显示体能状况评分、是否接受全身治疗、EGFR状态是影响OS2的相关因素。在Cox多因素分析中,是否接受全身治疗是影响OS2的相关因素。结论肺腺鳞癌患者应警惕早期出现脑转移风险,当发现出现脑转移,给予患者合适、个体化的治疗可在一定程度上改善预后。Objective To analyze the prognosis of lung adenosquamous carcinoma complicated with brain metastases.Methods Clinical data of 36 lung adenosquamous carcinoma patients with brain metastases admitted in our hospital from August 2008 to December 2014 were retrospectively analyzed.The survival analysis was performed using Kaplan-Meier method.Total survival time(OS1 and OS2),and the related factors affecting OS were analyzed.Results There were 30 patients had brain metastases at the time of initial diagnosis.Twenty-one patients underwent EGFR gene testing and 5 patients with EGFR mutations received targeted therapy.Thirty patients received whole brain radiotherapy(WBRT).The median TTB time of the patients was 6.7 months(95%CI:5.057~8.343 months).The median OS1 of 36 patients was 14.5 months(95%CI:11.877~17.123 months);the median 0S2 was 8.5 months(95%CI:7.658~9.342 months).The PS score(P=0.028),systemic treatment(P<0.01),and EGFR status(P=0.045)were independent predictors for OS1 in univariate analysis.In Cox multivariate analysis,systemic therapy was the independent factor affecting OS2.Conclusion The risk of early brain metastasis should be alerted in patients with lung adenosquamous carcinoma.When brain metastasis is found,appropriate and individualized treatment can improve the prognosis of patients to certain extent.

关 键 词：肺癌 腺鳞癌 脑转移 生存 预后 

分 类 号：R73[医药卫生—肿瘤]