乳腺癌脑转移68例临床特点及预后因素分析

An Analysis of Clinical Feature and Prognosis in 68 Cases with Brain Metastasis from Breast Cancer

[目的]分析乳腺癌脑转移患者的临床特点,探讨影响乳腺癌脑转移患者预后的因素。[方法]收集68例乳腺癌脑转移患者临床资料,采用单因素和多因素生存分析影响乳腺癌脑转移患者预后因素。[结果]乳腺癌脑转移患者多为未绝经、浸润性导管癌,首发症状多为颅内高压症状,多为多发颅内转移,多合并颅外转移。乳腺癌脑转移患者中位生存期8.82个月,1、2、3年生存率分别为39%、8%、8%。单因素分析显示KPS评分、合并肝转移、全身化疗、脑部放疗显著性影响乳腺癌脑转移患者的生存期;Cox多因素分析显示脑部放疗、KPS评分是影响乳腺癌脑转移生存的独立预后因素。[结论]脑部放疗、KPS评分是影响乳腺癌脑转移患者生存的独立预后因素。乳腺癌脑转移后的全身化疗价值需进一步探讨。

[Purpose] To investigate the clinical characteristics and prognosis in breast cancer patients with brain metastasis. [Methods] Sixty-eight cases with brain metastasis from breast cancer were eligible for this analysis, prognostic factor was analyzed by univariate and multivariate survival analysis.[Results] The breast cancer patients with brain metastasis were mostly premenopausal women, pathologic type was mainly infiltrative ductal carcinoma. First symptom was mostly intracranial hypertension syndrome. Most of the patients presented with multiple intracranial lesions and extracranial metastasis. The median survival was 8.82 months, and the 1, 2, 3-year overall survival was 39%, 8%, 8%, respectively. Univariate analysis showed that KPS, hepatic metastasis, chemotherapy and brain radiotherapy were significantly factors those impacted on patient’s prognosis. Cox multivariate analysis showed that radiotherapy and KPS were independent prognostic factors.[Conclusion] Brain radiotherapy and KPS are independent prognostic factors. The function of chemotherapy after brain radiotherapy needs further study.