大分割立体定向放射治疗对非小细胞肺癌脑转移瘤的疗效评估

The treatment evaluation of hypofractionated stereotactic radiotherapy for brain metastases of non-small cell lung cancer

目的探讨伽玛射线大分割立体定向放疗(SRT)加或不加全脑放疗(WBRT)对肺癌有限脑转移瘤治疗的疗效。方法回顾性分析非小细胞肺癌多发脑转移瘤(1~4枚)患者66例,其中单纯SRT 30例,SRT+WBRT 36例。分析两组患者的临床特征并应用Kaplan-Meier法计算生存率,用Logrank法对各因素进行预后分析。结果两组患者的临床特点无明显区别;SRT组与WBRT+SRT组的中位生存期(MST)分别为12.1与13.3个月,两者无显著性差异(P=0.216)。Logrank分析显示卡氏评分(P=0.017)和颅外病变的控制情况(P=0.032)是影响预后的主要因素。结论SRT是非小细胞肺癌有限脑转移瘤患者有效治疗手段,单纯SRT可取得与WBRT加SRT相似的生存期。

Objective To analyze the results of stereotactic radiationtherapy（SRT）with or without whole-brain radiotherapy（WBRT）in the treatment of limited number brain metastasis of non-small cell lung cancer（NSCLC）.Methods Retrospective analyzed 66 NSCLC patients with brain metastases within 4 lesions.30 cases were treated with SRT alone and 36 with SRT＋WBRT.Each groups＇ clinical characters were summarized.Kaplan-Meier and Logrank analyses were used for survival analysis.Results No significant differences were found in clinical characteristics of each groups.The median overall survival time was 12.6 months for the whole group.There was no difference between SRT alone group and SRT＋ WBRT group（12.1 months vs.13.3 months,P=0.216）.The Karnofsky Performance Score（KPS）at the time of treatment（P=0.017）and the status of extracranial metastases（P=0.032）were the most important two prognosis factors for survival in Logrank analyses.Conclusion Stereotactic radiation therapy is an effective treatment for limited number brain metastases of NSCLC.The patients who accepted SRT alone or SRT＋WBRT have the similar overall survival time.