非小细胞肺癌脑转移患者107例预后分析

The prognostic analysis for non-small cell lung cancer with brain metastases in 107 cases

目的 探讨不同治疗方法以及其他临床因素对非小细胞肺癌脑转移患者预后的影响.方法 对2010年1月至2011年12月在湖北医药学院附属人民医院进行治疗的107例非小细胞肺癌脑转移患者进行随访,了解其生存时间,并收集临床资料,分析各种治疗方式及临床特征对其预后的影响.结果 107例患者的平均生存期为（11.93±5.53）个月,中位生存期为11个月,6个月、1年和2年生存率分别为90.7％、41.1％和6.4％.Cox回归分析结果显示,颅外病灶控制、Karnofsky评分、靶向治疗和年龄为患者预后的独立影响因素,OR值分别为0.358（95％CI0.217 ～ 0.593）、0.302（95％CI0.182～0.502）、0.170（95％CI0.098 ～ 0.296）和1.635（95％CI1.010 ～ 2.647）,均P＜0.05.结论 放射治疗是非小细胞肺癌脑转移瘤的有效治疗手段,生物靶向治疗可以有效地延长生存期,另外患者的生存期还与年龄、Karnofsky评分以及颅外病灶控制情况等因素有一定关系.

Objective To evaluate the clinical efficacy of different treatments on non-small cell lung cancer （NSCLC） patients with brain metastases and to explore the influential factors of the prognosis.Methods The NSCLC patients with brain metastases treated from Jan.2010 to Dec.2011 were follow-up.The survival time and influences resulted from the treatments were analyzed.Results The average survive time of these patients was （11.93±5.53） months,and the median survive time was 11 months.The 6-month,1-year and 2-year overall survival rates were 90.7 %,41.1% and 6.4 %,respectively.Multivariate analysis showed that control of extracranial lesions,Kamofsky score,target therapy and age were independent predictive factors of survival,and the OR value were 0.358 （95 % CI0.217-0.593）,0.302 （95 % CI 0.182-0.502）,0.170 （95 % CI 0.098-0.296） and 1.635 （95 % CI 1.010-2.647）,respectively （all P 〈 0.01）.Conclusions Radiation therapy is an effective treatment on non-small cell lung cancer with brain metastases.Biological target therapy can effectively improve survival.The survival time also is correlated with age,Karnofsky score and control of extracranial lesions.