治疗65例肺癌脑转移探讨

The discussion of treatment result for 65 patients with brain metastases from lung cancer

目的：探讨影响肺癌脑转移综合治疗的预后因素及提高生存质量的可能性。方法：１９９０ 年３月～１９９５ 年３ 月间对６５ 例肺癌脑转移患者行单纯放疗及手术切除加放疗。放疗（ 全脑） 分为２ 组：常规放疗剂量２２ ～４０ Ｇｙ／２ ．２ ～４ｗ ，后缩野追加１５ ～２０ Ｇｙ／１ ．５ ～２ｗ ；全脑快速照射剂量１８ ～２４ Ｇｙ／１１ ～１５ｗ ，后缩野追加１５ ～２０ Ｇｙ／１５ ～２０ｗ 。结果：手术切除加放疗的中位生存期９５ 个月和１ 年生存率６２３ ％ ，显著优于单放组的５５ 个月和１４５ ％ （ Ｐ＜ ００５） 。全脑快速照射能迅速缓解症状，未能提高生存率。结论：肺癌脑转移采用手术加放疗的疗效比单纯放疗好。

Objective:To investigate the treatment result for lung cancer with brain metastases.Methods:65 patients with brain metastases from lung cancer were given radiotherapy alone or surgery followed by radiotherapy from March,1990 to March,1995.Radiotherapy(whole brain irradiation) were divided into two groups:The conventional fraction radiotherapy given with the dose of 22～40Gy in 2.2～4 weeks (whole brain irradiation) then followed with 15～20Gy in 1.5～2 weeks booster;The accelerated radiatherapy was given with the dose of 18～24Gy in 1.1～1.5 weeks (whole brain irradiation) then followed with 15～20Gy in 1.5～2 weeks booster. Results:The median survival period and one year survival rate were 9.5 months and 62.3% in srugery plus radiotherapy group and 5.5 months and 14.5% in radiotherapy alone group( P <0.05).The accelerated radiotherapy of whole brain irradiation could alleviate the patient′s symptom quickly,but couldn′t improve the survival rates.Conclusions:Combined therapy of surgery plus radiotherapy is better than radiotherapy alone for brain metastasis from lung cancer.