非小细胞肺癌脑转移患者预后多因素Cox回归分析

Survival analysis of non-small cell lung cancer patients with brain metastases by Cox regression

目的探讨影响非小细胞肺癌（non-small cell lung cancer,NSCLC）脑转移患者生存时间的因素。方法回顾性分析我院收治的NSCLC脑转移并行头颅放疗患者302例,其中资料完整者171例进行分析。采用SPSS13.0统计软件行影响生存期的单因素及多因素Cox风险比例模型回归分析。探讨患者的临床特征及放疗方式等因素对患者生存期的影响。结果全组患者中位生存期为8.8（95%CI：7.2～10.3）个月;单因素分析显示：PS评分（P=0.002）、脑转移数量（P=0.023）、脑转移时间（P=0.031）、放疗方式（P=0.041）和肺癌是否切除（P=0.002）与患者预后有关;Cox多元回归分析显示：PS评分（P=0.04）和肺癌是否手术切除（P=0.04）为脑转移患者独立预后因素而与脑转移数量（P=0.65）、脑转移时间（P=0.71）、放疗方式（P=0.91）等因素无关。结论 NSCLC脑转移整体预后较差,手术切除肺部肿瘤且体力评分较好患者预后相对较好。

Objective To evaluate the prognosis factors for non-small cell lung cancer patients with brain metastases. Methods The clinical data of 302 patients of non-small cell lung cancer patients with brain metastases were reviewed,and only 171 cases with adequate survival data were analyzed respectively. The clinical factors and treatment procedures were analyzed by univariate analysis and Cox regression to evaluate the effect on prognosis. Results The overall median survival time for this group patients was 8. 8（ 95% CI： 7. 2 ～ 10. 3） months. The univariate analysis demonstrated the PS score（ P = 0. 002）,number of brain metastasis（ P = 0. 023）,time of brain metastases（ P = 0. 031）,radiotherapy methods（ P = 0. 041） and tumor resection in lung（ P = 0. 002） were associated with the prognosis. In the Cox regression analysis,the PS score（ P = 0. 04） and lung surgery（ P = 0. 04） were independent prognosis factors for NSCLC patients with brain metastases,but they had no relationship with number of brain metastasis（ P = 0. 65）,time of brain metastases（ P = 0. 71） and radiotherapy methods（ P = 0. 91）. Conclusion The general prognosis of NSCLC patients with brain metastases is poor. Patients with lung carcinoma resection and good quality of physical activity may have a superior prognosis.