肺癌脑膜转移患者的临床特征及预后因素分析

Clinical features and prognostic factors of lung cancer-induced leptomeningeal metastasis

目的探讨肺癌脑膜转移癌(leptomeningeal metastases,LM)患者的临床特点和治疗方法。方法回顾性分析71例肺癌脑膜转移患者的临床特征和随访资料,采用Kaplan-Meier法绘制生存曲线,并分析影响LM患者预后的因素。结果 71例LM患者的中位生存时间为150 d,1年生存率为22.5%(16/71)。单因素分析显示,KPS评分、原发性肿瘤控制情况、治疗情况、近期疗效及直接死亡原因与LM患者的生存时间有关(均P<0.05)。多因素分析显示,近期疗效及直接死亡原因是影响LM患者预后的独立因素(均P<0.05)。结论近期疗效及直接死亡原因影响肺癌脑膜转移患者的预后生存。应用全身治疗联合局部治疗有助于延长肺癌脑膜转移患者的生存时间,改善预后。

Objective To discuss the clinical features, treatment strategies, and prognostic factors of lung cancer-induced leptomeningeal metastasis （LM）. Method This retrospective analysis studied the clinical and follow-up data of 71 patients with LM in our hospital. Patients＇ survival curves were plotted using the Kaplan-Meier approach, and factors influencing patient prognosis were analyzed. Result The median survival time of these 71 patients was 150 d, and the 1- year survival rate was 22.5% （16/71）. Univariate analysis showed that the KPS score, control of primary tumor, treatment strategy, short-term efficacy, and direct cause of death were significantly associated with the survival of patients with LM （P〈0.05 for all factors）. Multivariate analysis identified short-term efficacy and direct cause of death as the independent prognostic factors for patients with LM （P〈0.05 for both factors）. Conclusion Both of the short-term efficacy and direct cause of death are independent prognostic factors for patients with LM, Combined treatment （systemic treatment and lo- cal treatment） could prolong the survival of these patients, and improve prognosis.