肺腺癌脑转移全脑放疗诱导的淋巴细胞减少对患者预后的影响  

Effect of whole-brain radiation-induced lymphocytosis on prognosis in patients with lung adenocarcinoma with brain metastasis

作　　者：张吉瑞 范育伟 杨涛 周冲[2] 夏铀铀 ZHANG Jirui;FAN Yuwei;YANG Tao(Department of Oncology,Affiliated Lianyungang Hospital,Xuzhou Medical University,Lianyungang 222000,CHINA)

机构地区：[1]徐州医科大学附属连云港医院(连云港市第一人民医院)肿瘤科,江苏222000 [2]徐州市中心医院肿瘤放疗科

出　　处：《江苏医药》2021年第2期188-191,共4页Jiangsu Medical Journal

基　　金：江苏省青年医学重点人才培养基金(QNRC2016498);徐州市临床技术骨干研修计划项目(2019GG004)。

摘　　要：目的探讨肺腺癌脑转移全脑放疗诱导的淋巴细胞减少对预后的预测价值。方法回顾性分析接受放疗的102例肺腺癌脑转移患者的临床资料。记录患者放疗前1周内外周血淋巴细胞绝对值(ALC)、放疗期间外周血淋巴细胞最低值(MinALC)和放疗后1个月的ALC,根据ALC将患者分为高ALC组(51例)和低ALC组(51例)。通过Kaplan-Meier法绘制生存曲线,采用log-rank法比较两组患者的生存差异,通过Cox比例风险回归模型进行单因素和多因素分析。结果全组中位随访时间为18个月,中位生存时间为11个月。1年总生存率(OS)为41%。放疗期间高、低ALC组患者的1年OS分别为57%和23%(P<0.01),中位生存时间分别为14个月和9个月。Cox多因素分析显示,美国东部肿瘤协作组评分(HR=2.03,95%CI=1.209~3.410,P<0.05)和放疗期间MinALC(HR=0.461,95%CI=0.279~0.761,P<0.05)为影响肺腺癌脑转移患者预后的独立因素。结论放疗期间MinALC对接受全脑放疗的肺腺癌脑转移患者的预后有一定预测价值。Objective To explore the value of lymphopenia in predicting the prognosis of the patients with brain metastasis of lung adenocarcinoma treated by whole-brain radiotherapy.MethodsThe data of 102 patients underwent whole-brain radiotherapy for brain metastasis of lung adenocarcinoma were retrospectively analyzed.The absolute value of lymphocyte(ALC) within one week before radiotherapy,the minimum value of lymphocyte(MinALC) during radiotherapy,and the absolute value of lymphocyte one month after radiotherapy were recorded.According to the ALC level,the patients were assigned into the high ALC group(51 cases) and low ALC group(51 cases).The Kaplan-Meier method was used to draw the survival curve,and the log-rank method was used to compare the survival difference between the two groups.Univariate and multivariate analysises were performed by Cox proportional risk regression model.Results The median follow-up time was 18 months,the median survival time was 11 months,and the one-year overall survival rate(OS) was 41%.The one-year OSs of the patients in the high ALC group and the low ALC group during radiotherapy were 57% and 23%(P<0.01) and the median survival times were 14 months and 9 months,respectively.Cox multivariate analysis showed that ECOG(HR=2.03,95%CI=1.209-3.410,P<0.05) and MinALC during radiotherapy(HR=0.461,95%CI=0.279-0.761,P<0.05) were the independent factors influencing the prognosis of the patients with brain metastasis of lung adenocarcinoma.Conclusion MinALC during radiotherapy has a certain value in predicting the prognosis of the patients underwent whole-brain radiotherapy for the brain metastasis of lung adenocarcinoma.

关 键 词：肺腺癌 脑转移 淋巴细胞 放疗 预后 

分 类 号：R730[医药卫生—肿瘤]