大分割立体定向放射治疗对非小细胞肺癌脑转移瘤的疗效评估

The Treatment Evaluation of Hypofractionated Stereotactic Radiotherapy for Brain Metastases of Non-small Cell Lung Cancer

背景与目的：立体定向放疗（stereotacticradiotherapv，SRT）与全脑放疗（wholebrainradiationtherapy’WBRT）是治疗脑转移瘤的主要手段。本文旨在探讨伽玛射线大分割SRT加或不加WBRT对肺癌有限脑转移瘤治疗的疗效。方法：回顾性分析非小细胞肺癌多发脑转移瘤（1～4枚）患者66例，其中单纯SRT30例，SRT＋WBRT36例。分析两组患者的临床特征并应用Kaplan-Meier法计算生存率．用Logrank法对各因素进行预后分析。结果：两组患者的临床特点无明显区别：SRT组与WBRT＋SRT组的中位生存期（MST）分别为12．1与1313个月，二者无显著性差异（P=0．216）。Logrank分析显示卡氏评分（P=0．017）和颅外病变的控制情况（P=0．032）是影响预后的主要因素。结论：SRT是非小细胞肺癌有限脑转移瘤患者有效治疗手段．单纯SRT可取得与WBRT＋SRT相似的生存期．

BACKGROUND ＆ OBJECTIVE： Stereotactic radiation therapy （SRT） and whole-brain radiotherapy （WBRT） are two important modalities to treat brain metastasis. In this study, we aimed to analyze the results of SRT with or without WBRT in the treatment of limited number brain metastasis of non-small cell lung cancer（NSCLC）. METHODS： We retrospectively analyzed 66 NSCLC patients with brain metastases within 4 lesions. Thirty cases were treated with SRT alone and 36 with SRT＋WBRT.Each groups clinical characters were summarized. Kaplan-Meier and Log-rank analyses were used for survival analysis. RESULTS： No significant differences were found in clinical characteristics of each groups. The median overall survival time was 12.6 months for the whole group. There was no difference between SRT alone group and SRT＋WBRT group （12.1 months vs 13.3 months,P = 0.216）.The Karnofsky Performance Score （KPS） at the time of treatment （P = 0.017） and the status of extracranial metastases （P = 0.032） were the most important two prognosis factors for survival in Log-rank analyses. CONCLUSION： Stereotactic radiation therapy is an effective treatment for limited number brain metastases of NSCLC.The patients who accepted SRT alone or SRT＋WBRT have the similar overall survival time.