非小细胞肺癌脑转移瘤的放疗疗效评价及预后分析

Evalauation effects of radiotherphy for brain metastases of non-small-cell lung carcinoma and muti-factor analysis of the prognosis

目的:评价非小细胞肺癌脑转移瘤患者接受两种不同放疗的疗效和生存预后因素。方法:对54例非小细胞肺癌脑转移患者进行放疗,其中行全脑+三维适形放疗37例,单纯三维适形放疗17例,用Kaplan-meier法统计生存率,以Cox比例风险模型分析影响患者生存的预后因素。结果:全脑+三维适形放疗中位生存期9个月,单纯三维适形放疗中位生存期7个月,两组差异无统计学意义(P>0.05)。结论:非小细胞肺癌脑转移三维适形放疗联合全脑照射无生存得益,多因素分析提示分级和脑转移肿瘤个数是影响预后的关键性因素。

Objective：To evaluate the therapeutic effects and factors affecting the patients′ survival of two different radiotherapies in the treatment of brain metastases of non-small-cell lung carcinoma（NSCLC）.Methods：In the fifty-four cases of brain metastases of NSCLC receiving radiotherapy,37 cases were treated with three-dimensional conformal radiotherapy（3D-CRT） and whde brain radiotherapy（WBR）,while the other 17 underwent 3D-CRT alone.Kaplan-Meier method was used to analyze the survival rate and local control rate,and Cox proportional hazards model was applied for determining the prognostic factors influencing the patients′ survival.Results：The median survival was 9 months for the patients who received 3D-CRT and WBR,The median survival was 7 monthes for the patients who simply received 3D-CRT.Statistics detected no significant difference between the two groups（P0.05）.Multivariate analysis showed that the recursive portioning analysis（RPA） and metastasis numbers were the independent prognostic factors for the patients′survival.Conclusions：WBR combined with 3D-CRT did not benefit the patients with brain metastases of NSCLC for their survival.RPA and metastasis numbers were the independent prognostic factors for the patients′survival.