经Ommaya囊脑室内化学治疗肺腺癌脑膜转移

Effect of intraventricular chemotherapy through Ommaya reservoir on meningeal metastasis from pulmonary adenocarcinoma

目的探讨在放、化疗的基础上经Ommaya囊脑室内化学治疗肺腺癌脑膜转移的有效性。方法将25例肺腺癌脑膜转移患者按随机数字表法随机分成Ommaya囊组（10例）与对照组（15例），并对两组患者的临床和随访资料进行比较分析。用Kaplan-Meier法进行生存分析并绘制生存曲线，组间差异分析采用Log-rank检验。结果患者术后Kamofsky评分较术前明显改善（P〈0．01），25例患者中位生存期为5．5个月（0．6-23个月），1年生存率为16．0％（4／25）。Ommaya囊组与对照组的中位生存时间分别为7个月和5个月，两者相较差异显著（P〈0．05）。结论肺腺癌脑膜转移患者预后差，在联合放化疗的基础上经Ommaya囊脑室内化疗能够有效提高患者生存质量，延长患者的生存时间。

Objective To analyze the effect of intraventricular chemotherapy （IVC） through Ommaya reservoir on the meningeal metastasis from pulmonary adenocarcinoma on the basis of the routine radiochemotherapy. Methods Twenty-five patients with meningeal metastases from the pulmonary adenocarcinomas were randomly divided into the IVC through Ommaya reservoir group （n=10） and the control group （n=lS）. The clinical and follow-up data in the patients of both the groups were compared. Survival status was analyzed and the survival curve was drawn by Kaplan-Meier method. Log-rank test was used to evaluate the differences in the prognoses between both the groups. Results Karnofsky scores were significantly improved compared to those before the treatment （P〈0.01） and the median survival time was 5.5 months （range： 0.6-23 months） in all the patients. One year survival rate was 16.0%（4/25） in these 25 patients. The median survival time （7 months） was significantly longer in IVC group than that （5 months） in the control group （P〈0.05）. Conclusions The prognoses in the patients with meningeal metastases from the pulmonary adenocarcinomas are very poor. It is suggested that their survival quantity may be enhanced and their survival time may be prolonged by IVC through Ommaya reservoir on the basis of the routine radiochemotherapy. But the curative effect of IVC through Ommaya reservoir on the patients with meningeal metastases from the pulmonary adenocareinomas still needed to be confirmed by the large sample and multicenter study.