摘要
背景和目的:肿瘤脑转移最常见于肺癌患者,放射治疗是其有效的常规治疗手段。目前的治疗以姑息止痛和减轻症状为目的,方法差异较大,对肺癌脑转移预后的认识也不尽相同。本研究通过回顾性分析肺癌脑转移患者放射治疗的疗效,以探讨其对预后影响的相关因素。材料和方法:对我院1994年1月至2000年12月资料完整的63例肺癌脑转移患者临床资料进行回顾性研究,所有患者接受放射治疗,其中42例合并使用化疗,放疗中位剂量为40Gy(24～62.4Gy)。t检验分析不同因素对平均生存期的差异,生存分析采用Kaplan-Meier法,Cox比例风险模型对预后因素进行分析。结果:放疗合并化疗者生存时间平均为9.5个月,单纯放疗者平均为6.3个月(P=0.043);治疗结束时有效和无效者的生存时间分别为9.3个月及5.0个月(P=0.042);放疗总剂量大于50Gy者为10.8个月,小于50Gy者6.7个月(P=0.028);单次剂量大于1.8Gy者为9.0个月,小于1.8Gy者4.8个月(P=0.015),差别均有统计学差异。生存分析发现放疗合并化疗及治疗结束时有效的患者预后较好。结论:放疗合并化疗与否和治疗结束时是否有效是肺癌脑转移放射治疗的独立预后因素。
Background & Objective:Brain metastasis is often found in the patients with lung cancer. Radiotherapy is regular and effective method, and it aims at palliating symptoms and prolonging survival time. However,now there are different viewpoints on protocols of radiotherapy and prognostic factors. A retrospective analysis was used to evaluate the results of treatment for 63 cases with brain metastasis from lung cancer and explore the prognostic factors. Materials and Methods: Sixty three patients of brain metastasis from lung cancer from Jan.1994 to Dec.2000 were studied retrospectively. All of them have received radiotherapy(RT) and 42 cases received combined chemotherapy. The median dose of radiotherapy was 40Gy(24～62 4 Gy). Mean survival times from two factors were compared by t test and the cumulative survival rate was analyzed by Kaplan Meier estimates, and the influencing factors were screened by Cox proportional hazard model. Results:The mean survival times were 9 5 months in the radiochemotherapy group and 6 3 months in radiotherapy alone group,9.3 months in good response group and 5.0 months in the poor response group (P=0 043), 10 8 months in the ≥50 Gy group and 6.7 months in the< 50 Gy group(P=0 028),and 10 months in ≥1.8 Gy fraction group and 4 8 months in the< 1.8 Gy fraction group (P=0 015). Survival analysis results suggested that the patients with combined chemotherapy and good response have better prognosis. Conclusions:Combined chemotherapy and efficacy at the end of treatment are independent prognosis factors of brain metastasis from lung cancer.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2002年第10期1141-1144,共4页
Chinese Journal of Cancer
关键词
肺肿瘤
脑转移肿瘤
放射疗法
化学疗法
预后
Lung neoplasm
Brain neoplasm/secondary
Radiotherapy
Chemotherapy
Prognosis
