肺癌脑转移患者放射治疗的危险因素及与预后的关系研究  

Risk factors for radiation encephalopathy and its relationship with prognosis in patients with lung cancer metastasis to brain

作　　者：高晖[1] 于娇[1] 黄凤仙[1] GAO Hui;YU Jiao;HUANG Feng-xian(Department of Radiotherapy,Shaanxi Provincial People's Hospital,Xi'an 710086,China)

机构地区：[1]陕西省人民医院放疗科,西安710086

出　　处：《中国肿瘤临床与康复》2022年第11期1318-1321,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨肺癌脑转移患者放疗治疗的危险因素及与预后的关系。方法选取2017年3月至2019年2月间陕西省人民医院收治的均接受放疗治疗的113例肺癌脑转移患者,根据随访放疗脑的发生情况分为放疗脑组34例和非放疗脑组79例,分析肺癌脑转移患者放疗脑的危险因素,比较两组患者的局部控制率,采用Kaplan-Meyer生存曲线分析放疗脑发生与患者生存率的关系。结果患者中位随访时间为放疗后12.5(3~36)个月。两组患者在年龄、EGFR突变、K-RAS突变、脑部症状、脑转移数目、放疗剂量和再次放疗方面比较,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析,年龄、EGFR突变、K-RAS突变和放疗剂量是肺癌脑转移患者放疗脑的独立危险因素(均P<0.05)。放疗脑组患者的局部控制率为41.2%,低于非放疗脑组的68.4%,差异有统计学意义(P<0.05)。Kaplan-Meyer生存曲线分析,放疗脑组患者1年累计生存率为26.9%,低于非放疗脑组的41.6%,差异有统计学意义(P<0.05)。不同个数危险因素患者1年累计生存率比较,差异有统计学意义(P<0.05)。有4个危险因素的患者1年累计生存率为17.5%,低于无危险因素患者的52.8%,差异有统计学意义(P<0.05)。结论肺癌脑转移患者放疗脑的发生与患者高龄、EGFR突变、K-RAS突变和放疗剂量有关,患者预后更差,需合理的治疗干预增加临床获益。Objective To analyze risk factors for radiation encephalopathy and its relationship with prognosis in patients with lung cancer metastasis to brain.Methods A total of 113 patients with brain metastases from lung cancer who underwent radiotherapy were selected at Shaanxi Provincial People's Hospital from March 2017 to February 2019.Based on the occurrence of radiation encephalopathy over the follow-up period,they were divided into a radiation encephalopathy group(34 patients)and a non-radiation encephalopathy group(79 patients).Risk factors for the occurrence of radiation encephalopathy was analyzed.Local control rates were compared between the two groups.Kaplan-Meyer survival curve was used to analyze the relationship between radiotherapy encephalopathy and survival rate.ResultsThe median follow-up time was 12.5(3 to 36)months.There were significant differences in age,EGFR mutation,K-RAS mutation,symptoms of brain,number of growths in brain,radiotherapy dose and repeat radiotherapy between the two groups(all P<0.05).Multivariate Logistic regression analysis revealed that age,EGFR mutation,K-RAS mutation and radiotherapy dose were independent risk factors for the occurrence of radiation encephalopathy in patients with lung cancer metastasis to brain(all P<0.05).The local control rate 41.2% in the radiation encephalopathy group which was lower than 68.4% of the non-radiation encephalopathy group(all P<0.05).Kaplan-Meyer survival curve analysis showed that the 1-year cumulative survival rate was 26.9% in the radiation encephalopathy group,which was significantly lower than 41.6%of the non-radiation encephalopathy group(all P<0.05).There were significant differences in 1-year cumulative survival rate in patients with different risk factors.The 1-year cumulative survival rate was 17.5%in patients with four risk factors,which was significantly lower than 52.8% of patients without risk factors(P<0.05).Conclusion The occurrence of radiation encephalopathy is associated with advanced age,EGFR mutation,K-RAS mutation and r

关 键 词：肺肿瘤 脑转移 放疗脑 危险因素 预后 

分 类 号：R734.2[医药卫生—肿瘤]