预后评分系统GPA在肺癌脑转移患者中的应用

Application of Prognostic Index Graded Prognostic Assessment(GPA) in Lung Cancer with Brain Metastases

[目的]评价GPA（graded prognostic assessment）分级在评价肺癌脑转移瘤患者预后中的作用。[方法]回顾性分析109例肺癌脑转移患者的临床资料,按GPA系统进行GPA评分,采用Kaplan-Meier进行生存分析并进行Log-rank检验。[结果]单因素分析显示患者的Karnofsky评分（KPS评分）、脑转移灶数目、颅外转移对肺癌脑转移患者生存期有影响（P〈0.05）。GPA 0~1分组中位生存期为8个月（95%CI：4.64~11.36）,1.5~2.5分组中位生存期12个月（95%CI：9.16~14.83）,3~4分组中位生存期25个月（95%CI：5.87~44.13）,不同GPA评分患者的中位生存期差异有统计学意义（χ2=7.467,P=0.024）。[结论]GPA作为一个预后模型,是有用的肺癌脑转移预测模型。

[Purpose] To investigate the role of graded prognostic assessment（GPA） in the evaluation of prognosis for lung cancer patients with brain metastasis. [Methods] The clinical data of 109lung cancer patients with brain metastases were reviewed retrospectively. GPA were evaluated according to GPA system. Survival was analyzed with Kaplan-Meier method and Log-rank test was used. [Results] The univariate analysis showed that Karnofsky score（KPS score）,number of brain metastases,extracranial metastasis had influence on survival of lung cancer patients with brain metastases（P＆lt;0.05）. The median survival was 8 months（95%CI：4.64~11.36） in group with GPA 0~1,12 months（95%CI：9.16~14.83） in group with GPA 1.5~2.5,25 months（95%CI：5.87~44.13） in group with GPA 3~4. The median survival of patients with different GPA score were statistically significant（χ2= 7.467,P=0.024）. [Conclusion] GPA is useful for prediction of brain metastases from lung cancer.