35例肺癌脑膜转移的临床观察

Clinical observation of 35 cases carcinoma meningitis secondary to lung cancer

目的探讨肺癌并脑膜转移的临床诊断、治疗及预后。方法收集35例脑膜转移患者的临床资料进行回顾性分析,并对影响预后的因素进行分析。结果 35例患者中24例接受了包括全身化疗、局部放疗、靶向治疗及鞘内化疗等抗肿瘤治疗,其余11例仅接受了侧脑室引流、甘露醇降颅压等对症支持治疗;两者的中位生存期分别为6.9个月和2.8个月,差异有统计学意义(P=0.005)。7例接受靶向治疗患者的中位生存期为10.0个月,17例接受放、化疗患者的中位生存期为5.1个月,差异有统计学意义(P=0.038)。Cox多因素回归分析显示,抗肿瘤治疗是影响预后的独立因素(HR=0.377,95%CI:0.152～0.936,P=0.035)。结论脑膜转移是晚期肺癌的严重并发症之一,预后较差,抗肿瘤治疗有助于延长生存期。

Objective To investigate the clinical diagnosis,therapy and prognosis of meningeal metastasis secondary to lung cancer.Methods The clinical data of 35 patients with meningeal metastasis secondary to lung cancer and the factor influencing the prognosis were retrospectively analyzed.Results Of the 35 patients,24 patients received therapies including systemic chemotherapy,radiotherapy,targeted therapy and intrathecal chemotherapy with the median survival time of 6.9 months and the median survival time was 2.8 months for 11 patients who received symptomatic and supported therapy（P=0.005）.The median survival time of 7 patients received targeted therapy was 10.0 months,while the other 17 patients received systemic chemotherapy and radiotherapy was 5.1 months（P=0.038）.Cox regression model showed that receiving anti-tumor therapy was the independent factor influencing the prognosis（HR=0.377,95%CI：0.152-0.936,P=0.035）.Conclusion Meningeal metastasis secondary to lung cancer with poor prognosis is one of the most serious complications of advanced lung cancer.Anti-tumor therapy can improve survival.