非小细胞肺癌脑转移的预后因素分析

Analysis of prognostic predictors of non-small cell lung cancer patients complicated with brain metastasis

目的探讨影响非小细胞肺癌脑转移治疗效果的预后因素。方法收集2006年3月-2009年3月在我科接受全脑放射治疗的57例非小细胞肺癌脑转移患者的临床资料,分析影响生存预后的各种因素。结果平均生存期可达到(9.7±2.8)个月。脑转移放疗后复发再次放疗组生存期(11.5月)优于复发后未放疗组(8.7月),无肺、骨转移组生存期(10.1月)优于有肺、骨转移组(8.5月),有显著统计学差异(P<0.05)。多因素分析结果显示:脑转移放疗后复发再次放疗,同步放化疗和无肺、骨转移是肺癌脑转移患者的独立预后因素(P<0.05)。结论影响非小细胞肺癌脑转移患者预后的主要因素是有无肺内、骨转移、是否采用同步放化疗,脑转移复发后是否再次放疗,选择同步放化疗以及对于脑转移放疗后复发的患者选择再次放疗的治疗方式,可以延长生存。

Objective To investigate the prognostic factors of non-small cell lung cancer patients complicat-ed with brain metastasis treatment. Methods The clinical data of 57 NSCLC patients complicated with brain metas-tases accepted the whole brain radiation therapy were retrospectively reviewed. Results The mean survival time was （9. 7 ± 2. 8） months. The survival time of the re-radiotherapy group was 11. 5 months, which was obviously longer than that of the non-radiotherapy group （8. 7 months）. The survival time of the patients without lung or bone metasta-ses （10. 1 months） was superior to those patients with lung or bone metastases （8. 5 months）. Multivariate analysis showed that the independent prognostic factors of NSCLC patients complicated with brain metastasis included re-radio-therapy after relapse, concurrent chemoradiotherapy, and lung and bone metastasis （P〈0. 05）. Conclusion The factors influencing the prognosis of NSCLC patients complicated with brain metastases include re-radiotherapy after re-lapse, concurrent chemoradiotherapy, and lung and bone metastasis. Re-radiotherapy after relapse and concurrent chemoradiotherapy can prolong their survival time.