驱动基因阴性非小细胞肺癌脑转移瘤患者放疗或伽玛刀联合放疗生存分析及其影响因素  

Survival analysis of patients with brain metastases from non-small cell lung cancer with driver gene negative radiotherapy or gamma knife combined radiotherapy and its influencing factors

作　　者：夏婧 杨秋安[1] XIA Jing;YANG Qiu′an(Department of Radiation Oncology,Qilu Hospital of Shandong University Eastern Court,Shandong Province,Ji′nan 250000,China)

机构地区：[1]山东大学齐鲁医院东院区肿瘤病房,山东济南250000

出　　处：《中国当代医药》2022年第18期80-83,共4页China Modern Medicine

摘　　要：目的探讨驱动基因阴性非小细胞肺癌脑转移瘤放疗或伽玛刀联合放疗患者生存差异及其影响因素。方法回顾性选取2018年1月至2021年1月山东大学齐鲁医院东院区收治的170例驱动基因阴性非小细胞肺癌脑转移瘤患者作为研究对象,根据治疗方式不同将其分为放疗组(135例)和伽玛刀联合放疗组(35例)。比较两组患者的生存期差异及相关影响因素。结果两组患者的总体生存期比较,差异无统计学意义(P>0.05)。Cox回归分析显示,放疗组内卡氏评分≥70分(β=-0.963,HR=0.382,95%CI=0.205~0.710)、最大病灶体积<10 ml(β=-0.567,HR=0.567,95%CI=0.335~0.962)是患者总生存期的保护因素(P<0.05)。伽玛刀联合放疗组内原发灶控制(β=-2.414,HR=0.089,95%CI=0.021~0.381)、转移灶个数小于4个(β=-2.730,HR=0.065,95%CI=0.013~0.323)是患者总生存期的保护因素(P<0.05)。结论驱动基因阴性非小细胞肺癌脑转移患者单独接受放射治疗或伽玛刀联合放疗,两组生存期并无差异。原发灶未进行有效控制或转移灶个数超过4个时,单独放射治疗患者生存期更长。Objective To investigate the difference of survival time and its related factors in non-small cell lung cancer patients with brain metastases and negative driver gene treated by radiotherapy and gamma knife combined with radiotherapy.Methods A total of 170 patients with brain metastases from non-small cell lung cancer with negative driver gene were selected retrospectively as the research subjects from January 2018 to January 2021 in Qilu Hospital of Shandong University Eastern Court.According to different treatment methods,they were divided into radiotherapy group(135 cases)and gamma knife combined radiotherapy group(35 cases).The difference in survival and related influencing factors were compared between the two groups.Results There was no significant difference between the two groups in overall survival time(P>0.05).Cox regression analysis showed that Karnofsky score≥70 points(β=-0.963,HR=0.382,95%CI=0.205-0.710)and maximum lesion volume<10 ml(β=-0.567,HR=0.567,95%CI=0.335-0.962)in the radio therapy group were protective factors for the overall survival of patients(P<0.05).In the gamma knife combined with radiotherapy group,the control of primary tumor(β=-2.414,HR=0.089,95%CI=0.021-0.381)and the number of metastatic lesions less than 4(β=-2.730,HR=0.065,95%CI=0.013-0.323)were the protective factors for the overall survivnl of patients(P<0.05).Conclusion Non-small cell lung cancer patients and negative driver gene received radiotherapy alone or gamma knife combined with radiotherapy,and there was no difference in survival time between the two groups.When the primary focus is not effectively controlled or the number of metastatic focus was more than 4,the survival time of patients treated with radiotherapy alone was longer.

关 键 词：放疗 伽玛刀 非小细胞肺癌 脑转移瘤 生存分析 

分 类 号：R734.2[医药卫生—肿瘤]