肺癌多发脑转移瘤的不同治疗方式近期疗效分析

Therapeutic Efficacy of Different Radiation Treatments for Multiple Brain Metastases from Lung Cancer

背景与目的:肺癌多发脑转移的发生率逐年上升,全脑放疗(WBRT)和X刀(SRS)治疗是其主要治疗手段之一。本文总结分析肺癌脑转移不同治疗方式的近期疗效。方法:回顾性分析39例肺癌多发脑转移病例,比较其不同治疗方式的近期疗效。结果:肺鳞癌患者治疗的有效率为86.7%,高于腺癌及其它类型癌(P=0.020)。转移瘤数目≤3个者的有效率为71.9%,明显高于>3个者(P=0.031)。SRS+WBRT治疗组近期有效率为77.8%,显著高于WBRT+SRS组及单纯WBRT组(P=0.026)。结论:低剂量X刀(SRS)治疗+WBRT对肺癌多发脑转移瘤的局部控制优于WBRT+SRS和单纯WBRT,特别是副作用轻,患者耐受性好。

BACKGROUND & OBJECTIVE: Multiple brain metastases from lung cancer is increasing in incidence year by year,and whole-brain radiotherapy(WBRT) and X-knife(SRS) are the main treatments.In this article,we analyzed the efficacy of different radiation treatment options for brain metastases from lung cancer.METHODS: We performed a retrospective analysis of 39 patients with multiple brain metastases from lung cancer,and compared the short term effect of radiation therapy.RESULTS: The response rate of patients with lung squamous cell carcinoma to radiation therapy was 86.7%,higher than other pathological types(P = 0.020).The response rate of patients with number of metastases less than or equal to 3 was significantly higher than that of patients with more than 3 metastases(P = 0.031).The short-term response rates were 77.8%,40.0%,and 28.6% for SRS+WBRT,WBRT+SRS,and WBRT alone group,respectively(P = 0.026).CONCLUSION: Low dose X-knife(SRS)+WBRT was more effective than WBRT+SRS or WBRT alone on the local control of multiple brain metastases from lung cancer,and showed less radiotherapy-induced side effects and better patient tolerance.