乳腺癌脑转移67例临床分析

Clinical Analysis of 67 Patients with Brain Metastases from Breast Cancer

背景与目的:随着乳腺癌全身治疗疗效的提高和患者生存期的延长,乳腺癌脑转移在临床上越来越常见。本研究通过分析乳腺癌脑转移的临床特点,探讨其治疗方式及预后因素。方法:67例患者出现脑转移距离确诊乳腺癌的时间为0～15年,中位时间为2.5年。治疗方式为手术加放疗3例,单纯放疗30例,单纯化疗3例,放疗加化疗26例,未治疗5例。采用SPSS10.0统计软件进行生存分析,采用Kaplan-Meier分析和log-rank检验进行生存预后分析。结果:乳腺癌脑转移最常见的症状是头痛,脑实质为最常受累部位。全组患者中位生存期为4年,出现脑转移后的中位生存时间为11个月。月经状况、脑转移数目、合并全身转移情况及治疗方式对患者的生存时间均无明显影响。结论:乳腺癌脑转移预后差,目前治疗仍以全脑放疗为主,化疗的作用还需进一步研究。

BACKGROUND ＆ OBJECTIVE： The incidence of brain metastases from breast cancer seems to be increasing with the improvement of systemic control and survival prolongation. This study was to analyze the clinical characteristics, treatment modalities, and prognostic factors of brain metastases from breast cancer. METHODS： The time from primary diagnosis of breast cancer to brain metastases of 67 breast cancer patients were 0-15 years, and the median time was 2.5 years. Of the 67 patients, 3 received surgery plus radiotherapy, 30 received radiotherapy alone, 3 received chemotherapy alone, 26 received radiochemotherapy, and 5 received no treatment. Kaplan-Meier analysis and log-rank test were used to analyze survival status. RESULTS： Headache was the most common symptom of brain metastases from breast cancer. The median survival time was 4 years. After brain metastases, the median survival time was 11 months. Menstrual status, number of brain metastases, systemic metastases, and different treatment modalities had no correlations to survival time of the patients. CONCLUSIONS： The prognosis of brain metastases from breast cancer is still poor. Radiotherapy remains the standard treatment of brain metastases. The function of chemotherapy needs further study.